Individual
DR. RICHARD LEE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
204 S LAFAYETTE ST, JERSEYVILLE, IL 62052-1657
(618) 498-1586
Mailing address
204 S LAFAYETTE ST, JERSEYVILLE, IL 62052-1657
(618) 498-1586
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2258
MO
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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