Light, Randy L

Light, Randy L is an individual health care provider with primary practice located at 1318 W Candletree Dr Suite 3, Peoria IL 61614-8508. He recently has only one registered license in Eye and Vision Services Providers / Ocularist, which is considered as his primary health care specialty. Light, Randy L can be contacted via phone (309) 676-3663.

Contact Information

Primary practice address
1318 W Candletree Dr Suite 3 Peoria IL 61614-8508
Phone: (309) 676-3663
Fax: (309) 676-0359
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Ocularist 156FX1700X 203.000116 Illinois

Profile Details

NPI number 1124060074
LBN Legal business name Light, Randy L
Credentials B.C.O., B.A.D.O.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jul 3rd, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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