NPI 1972550390

Lights Prosthetic Eyes INC

Organisation Ocularist Peoria, IL

Practice location

Address: 1318 W Candletree Dr STE 3, Peoria, IL 61614-8509
Phone: (309) 676-3663
Fax: (309) 676-0359

Authorised official

Name: Randy L Light
Title: President
Phone: (309) 676-3663

Registered specialties

Ocularist Primary

Eye and Vision Services Providers Taxonomy 156FX1700X Licence 203000116 (IL)

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Registry record

NPI: 1972550390
Entity type: Organization
NPI issued: 30 May 2006
Record last updated: 3 Jul 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.