| NPI | 1316062847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA A GLIBERTY Administrator 603-434-4193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |