| NPI | 1194043000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELENE MARIE BRADLEY Optometrist 401-828-4838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: RI ODTA00411) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: RI ODTG00544) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2011-10-28 |