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General NPI Number Information
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NPI Number | 1518270602
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Entity Type | Organization
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Legal Business Name | HOLLISTON VISION CENTER INC
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 05/14/2012
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Provider Practice Location Address
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Address Line | 841 WASHINGTON ST
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City | HOLLISTON
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State | MA
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Zip | 01746-1690
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Country | US
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Telephone | 508-429-1330
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Fax | 508-429-0922
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Provider Business Mailing Address
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Address Line | 841 WASHINGTON ST
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City | HOLLISTON
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State | MA
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Zip | 01746-1690
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Country | US
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Telephone | 508-429-1330
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Fax | 508-429-0922
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. ROSELYN JEUN
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Credential |
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Telephone | 508-429-1330
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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 | 4086
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License Number State | MA
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