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General NPI Number Information
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NPI Number | 1982873428
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Entity Type | Organization
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Legal Business Name | DRS. MONTMINY, INC.
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 75 ARCAND DR
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City | LOWELL
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State | MA
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Zip | 01852-1026
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Country | US
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Telephone | 978-459-0702
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Fax |
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Provider Business Mailing Address
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Address Line | 75 ARCAND DR
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City | LOWELL
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State | MA
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Zip | 01852-1026
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Country | US
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Telephone | 978-459-0702
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | MR. GEORGE ROBERT MONTMINY
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Credential | O.D.
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Telephone | 978-459-0702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 2264
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License Number State | MA
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