| NPI | 1700910775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAO CHE Optometrist 978-531-7217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4517) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NH 0774) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2008-06-16 |