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General NPI Number Information
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NPI Number | 1528538402
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Entity Type | Organization
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Legal Business Name | OCULAR PRO SERVICES LLC
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Dates
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Enumeration Date | 12/04/2018
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Last Update Date | 12/04/2018
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Provider Practice Location Address
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Address Line | 5 DODGE ST # 109
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City | BEVERLY
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State | MA
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Zip | 01915-1703
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Country | US
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Telephone | 857-327-5599
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Fax | 978-279-1117
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Provider Business Mailing Address
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Address Line | 5 DODGE ST # 109
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City | BEVERLY
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State | MA
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Zip | 01915-1703
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Country | US
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Telephone | 857-327-5599
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Fax | 978-279-1117
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Authorized Official
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Title or Position | CEO
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Name | DR. ALEXANDER RICHARD MARTIN
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Credential | OD
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Telephone | 857-327-5599
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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 |
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License Number State |
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