| NPI | 1235290867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL J WASSON Clerk 617-472-5242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: MA 5617) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: MA 5617) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2013-07-02 |