MEDICARE: DR. MARIE KATHLEEN SALVAS O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3081	MA

General Provider Information

NPI Number	:	1538162847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE KATHLEEN SALVAS O.D.

Provider Business Mailing Address
First Line	:	1105 LAKEVIEW AVE
Second Line	:	STE 4
City	:	DRACUT
State	:	MA
Zip	:	01826-4762
Country	:	US
Telephone Number	:	978-957-5665
Fax Number	:

Provider Business Practice Location Address
First Line	:	1105 LAKEVIEW AVE
Second Line	:	STE 4
City	:	DRACUT
State	:	MA
Zip	:	01826-4762
Country	:	US
Telephone Number	:	978-957-5665
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/26/2016

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