TIM A BENGTSON O.D., P.C.
Optometry at Jackson St, Macomb, IL

License number
Illinois 046007904
Category
Optometry
Type
Optometrist
Owner
Name: TIM BENGTSON
Title: OWNER
Phone: (309) 833-4242
Address
Address
820 E Jackson St, Macomb, IL 61455
National Provider ID: 1285646661
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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TIM A. BENGTSON, O.D., PC

Macomb, IL 61455

Registration:
Dec 5, 2003
State ID:
63206466
Business type:
DOMESTIC BCA
Expiration:
PERPETUAL
Agent:
Tim A. Bengtson,820 E Jackson St, Macomb, IL 61455 (Physical)

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