Organization
PATRICK NIEBRUGGE OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK M NIEBRUGGE OD (OPTOMETRIST)
(217) 932-2310
Entity
Organization
Contact information
Practice address
1279 E US HWY 40, CASEY, IL 62420-0528
(217) 932-2310
(217) 932-4674
Mailing address
PO BOX 528, 1279 E US HWY 40, CASEY, IL 62420-0528
(217) 932-2310
(217) 932-4674
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0706010001
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046007315
—
IL
01
—
1831228600
NPI
IL
Enumeration date
09/05/2007
Last updated
02/21/2008
Update your record
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