| NPI | 1003203852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDI MCMICHAEL Optometrist 617-866-7582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA 15144TLG) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2015-04-20 |