Individual
DR. CHARLES E MCCOLLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1302 ENTERPRISE WAY, MARION, IL 62959
(618) 997-6922
(618) 993-3561
Mailing address
1302 ENTERPRISE WAY, PO BOX 1754, MARION, IL 62959
(618) 997-6922
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046006995
IL
152W00000X
Optometrist
047-006995
IL
Other
Enumeration date
08/29/2006
Last updated
10/15/2011
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