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General NPI Number Information
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NPI Number | 1609688597
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Entity Type | Individual
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Provider Name | GEORGE CROSS RDO
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Gender | Male
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 326 NICHOLS RD
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City | FITCHBURG
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State | MA
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Zip | 01420-1914
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Country | US
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Telephone | 978-878-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 20 MAIN ST APT 3B
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City | LEOMINSTER
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State | MA
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Zip | 01453-5530
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Country | US
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Telephone | 617-413-6512
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 6404
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License Number State | MA
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