| |
250 Granite St, Space 1041c, Braintree, MA 02184-2804 | |
(210) 524-6982 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 250 Granite St, Braintree, Massachusetts |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386074433 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
175 E Houston St, San Antonio, TX 78205-2299 Ph: (800) 340-0129 | 250 Granite St, Space 1041c, Braintree, MA 02184-2804 Ph: (210) 524-6982 |