Healthcare Provider Details

I. General information

NPI: 1780856245
Provider Name (Legal Business Name): ACUITY EYECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 05/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 MAIN ST
SALEM NH
03079-3186
US

IV. Provider business mailing address

223 MAIN ST
SALEM NH
03079-3186
US

V. Phone/Fax

Practice location:
  • Phone: 603-893-8628
  • Fax: 603-893-4076
Mailing address:
  • Phone: 603-893-8628
  • Fax: 603-893-4076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number620
License Number StateNH

VIII. Authorized Official

Name: DR. BETH H KOHN
Title or Position: OWNER
Credential: O.D.
Phone: 603-893-8628