| NPI | 1790235190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY ANNE DUBE Optician 781-438-2122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MA 1538234059) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2016-10-10 |