| |
198 Colony Place, Plymouth, MA 02360 | |
(508) 732-0196 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 198 Colony Place, Plymouth, Massachusetts |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982024014 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 417821, Boston, MA 02241-7821 Ph: () - | 198 Colony Place, Plymouth, MA 02360 Ph: (508) 732-0196 |