| NPI | 1801172259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIMEE GRAY PICKETT Owner 508-994-8092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4197) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: MA 4197) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2013-04-12 |