| NPI | 1528128105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL J WASSON Clerk 617-472-5242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: MA 4394) |
| Additional Taxonomies | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2013-06-21 |