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General NPI Number Information
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NPI Number | 1053272708
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Entity Type | Individual
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Provider Name | CHARLOTTE FERN MILLER LDO
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Gender | Female
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 294 COMMERCIAL ST
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City | PROVINCETOWN
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State | MA
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Zip | 02657-2229
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Country | US
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Telephone | 508-487-2408
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1435
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City | PROVINCETOWN
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State | MA
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Zip | 02657-5435
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Country | US
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Telephone | 800-604-2406
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 6838
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License Number State | MA
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