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Mr. David A Blissenbach
Optician in E St Louis, Illinois
NPI 1407895014

David A Blissenbach is a Optician based in Cahokia, IL and is specialized in Optician. David A Blissenbach practices in E St Louis, IL. The NPI Number for David A Blissenbach is 1407895014 and holds a License No. (Illinois).

The current practice location address for David A Blissenbach is 100 N 8Th St, E St Louis, IL and can be reached out via phone at 618-274-2020.

Location: 100 N 8Th St, E St Louis, IL, 62206-3105
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407895014
Provider Name
David A Blissenbach
Credential
Provider Entity Type
Individual
Gender
Male
Address
100 N 8Th St, E St Louis, IL, 62206-3105
Phone Number
618-274-2020
Fax Number
Provider Enumeration Date
06/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
371210755001 05 IL
institution
Provider Business Practice Location Address Details
Address
100 N 8Th St
City
E St Louis
State
Illinois
Zip
62201-2989
Phone Number
618-274-2020
Fax Number
person
Provider Business Mailing Address Details
Address
100 N 8Th St
City
E St Louis
State
Illinois
Zip
62201-2989
Phone Number
618-274-2020
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
()
Definition
Definition to come...
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