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Tim A Bengtson O.D., P.C.

Optometrist in Macomb, IL. Organization (NPI-2).

NPI number1285646661
StatusActive
Last updated in NPPESMay 8, 2008

Details

NPI
1285646661
Entity type
Organization (NPI-2)
Legal business name
Tim A Bengtson O.D., P.C.
Organization subpart
No
Enumeration date
Aug 13, 2006
Last updated
May 8, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist046007904ILYes

Practice location

820 E Jackson St
Macomb, IL 61455-2412

Phone 309-833-4242

Mailing address

820 E Jackson St
Macomb, IL 61455-2412

Authorized official

Tim Bengtson
Owner
3098334242

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