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General NPI Number Information
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NPI Number | 1346381563
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Entity Type | Organization
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Legal Business Name | AUBURN VISION CENTER INC
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 59 AUBURN ST
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City | AUBURN
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State | MA
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Zip | 01501-2428
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Country | US
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Telephone | 508-832-8820
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Fax | 508-721-5145
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Provider Business Mailing Address
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Address Line | 3 CALVINS LN
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City | STERLING
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State | MA
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Zip | 01564-2213
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Country | US
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Telephone | 978-563-1600
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Fax | 603-954-8386
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL PAUL LARSEN
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Credential | O.D.
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Telephone | 508-832-8820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | MA3972
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License Number State | MA
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