| NPI | 1275111502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARSHA WEAVER Vice President 617-483-5974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-05-03 |