Healthcare Provider Details

I. General information

NPI: 1669664496
Provider Name (Legal Business Name): ADAPTIVE TECHNOLOGY CONSULTING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 BRIDGE RD ADAPTIVE TECHNOLOGY CONSULTING, INC.
SALISBURY MA
01952-2414
US

IV. Provider business mailing address

PO BOX 778 ADAPTIVE TECHNOLOGY CONSULTING, INC.
AMESBURY MA
01913-0017
US

V. Phone/Fax

Practice location:
  • Phone: 978-462-3817
  • Fax: 978-462-3928
Mailing address:
  • Phone: 978-462-3817
  • Fax: 978-462-3928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State

VIII. Authorized Official

Name: MS. GAYLE LESLIE YARNALL
Title or Position: PRESIDENT
Credential:
Phone: 978-462-3817