NPI | 1235688557 |
---|---|
Entity Type | Organization |
Authorized Contact | JACKY KONG President 617-818-0476 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4689) |
Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: MA 4687) |
152WP0200X Optometrist, Pediatrics (Licence: MA 4689) | |
152WS0006X Optometrist, Sports Vision (Licence: MA 4689) | |
152WV0400X Optometrist, Vision Therapy (Licence: MA 4689) | |
Enumeration Date | 2016-09-27 |
Last Update Date | 2016-09-27 |