| NPI | 1063679082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELENA VOLNOVA Optician 781-329-5120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MA 6080) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-19 |