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Eye and Vision Services Providers Optometrist

Provider NPI: 1720539240

Organization Information:
Organization is Subpart
Authorized Official:  COREY B WESTERFELD  CHIEF MEDICAL OFFICER  508-994-1400

Practice Location:
Tel: 401-769-2511  Fax: 401-769-7696

Business Mailing Address:
51 STATE RD  DARTMOUTH, MA 02747-3319 US
Tel: 774-320-3040  Fax: 508-910-2204

NPI Information:
NPI: 1720539240
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N152W00000XEye and Vision Services Providers
N156FX1800XEye and Vision Services Providers
Eyewear Supplier (Equipment, not the service)

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 332H00000X





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