Organization
ALLIED VISION SOURCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT W JONES O.D. (PRESIDENT)
(217) 663-0118
Entity
Organization
Contact information
Practice address
2475 N MONROE ST, DECATUR, IL 62526-3941
(217) 663-0118
Mailing address
2475 N MONROE ST, DECATUR, IL 62526-3941
(217) 663-0118
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.06977
IL
Other
Enumeration date
09/14/2015
Last updated
03/25/2019
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