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General NPI Number Information
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NPI Number | 1467261248
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Entity Type | Organization
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Legal Business Name | LUMINA VISION THERAPY
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 11 SUMMER ST
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City | CHELMSFORD
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State | MA
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Zip | 01824-3064
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Country | US
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Telephone | 978-726-4071
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Fax |
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Provider Business Mailing Address
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Address Line | 14 GALVIN PL
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City | DEDHAM
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State | MA
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Zip | 02026-3017
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BEHAVIORAL OPTOMETRIST
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Name | JESSICA SHIPS
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Credential | OD
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Telephone | 978-726-4071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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