Individual
KERRY HOWARD HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
205 TENNEY ST, KEWANEE, IL 61443-3494
(309) 854-0010
(309) 854-0010
Mailing address
205 TENNEY ST, KEWANEE, IL 61443-3494
(309) 854-0010
(309) 854-0012
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
047928330
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47924
DAVIS VISION
IL
Enumeration date
10/06/2006
Last updated
11/14/2022
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