Organization
TALLIS OPTOMETRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY EDWIN TALLIS OD (OWNER)
(309) 827-8434
Entity
Organization
Contact information
Practice address
915 N MAIN ST, BLOOMINGTON, IL 61701-3043
(309) 827-8434
(309) 828-6741
Mailing address
915 N MAIN ST, BLOOMINGTON, IL 61701-3043
(309) 827-8434
(309) 828-6741
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
02/21/2020
Last updated
03/04/2020
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