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General NPI Number Information
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NPI Number | 1619906591
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Entity Type | Individual
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Provider Name | PHILIP MICHAEL ARSENAULT O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 250 GRANITE ST SUITE NUMBER 2069
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City | BRAINTREE
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State | MA
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Zip | 02184-2804
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Country | US
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Telephone | 781-849-9944
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Fax | 781-848-1023
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Provider Business Mailing Address
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Address Line | 71 THAYER AVE
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City | WEST BRIDGEWATER
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State | MA
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Zip | 02379-1328
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Country | US
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Telephone | 508-559-8764
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | MA4347
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License Number State | MA
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