NPI | 1043696602 |
---|---|
Doing Business As | DR. TARA L. SULLIVAN, O.D. |
Entity Type | Organization |
Authorized Contact | TARA LEANNE SULLIVAN Owner & Optometrist 781-270-7499 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5072) |
Enumeration Date | 2015-08-06 |
Last Update Date | 2015-08-06 |