| NPI | 1881784585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY LANE IMMERMAN Owner 617-698-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: MA MA3103) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |