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General NPI Number Information
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NPI Number | 1528718509
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Entity Type | Organization
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Legal Business Name | CHRISTIAN IYORE INC
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Dates
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Enumeration Date | 03/24/2022
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Last Update Date | 03/24/2022
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Provider Practice Location Address
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Address Line | 80 ERDMAN WAY # 205
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City | LEOMINSTER
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State | MA
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Zip | 01453-1840
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Country | US
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Telephone | 978-696-5674
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Fax |
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Provider Business Mailing Address
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Address Line | 270 DOUGLAS RD
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City | LOWELL
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State | MA
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Zip | 01852-3912
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Country | US
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Telephone | 978-590-0126
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Fax |
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Authorized Official
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Title or Position | CEO/OPTOMETRIST
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Name | DR. CHRISTIAN E IYORE
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Credential | OD
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Telephone | 978-590-0126
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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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