| NPI | 1659582492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUBOV NASCIMENTO Manager 617-923-2022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |