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NPI Code Detail

MEDICARE: COBB CORNER EYE CARE

MEDICARE: COBB CORNER EYE CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist3021MA

General Provider Information

NPI Number : 1558459800
Entity Type Code : Organization
Provider Name (Legal Business Name) : COBB CORNER EYE CARE
Provider Business Mailing Address
First Line : 89 SHARON ST
Second Line :
City : STOUGHTON
State : MA
Zip : 02072-2011
Country : US
Telephone Number : 781-344-3331
Fax Number : 781-344-4717
Provider Business Practice Location Address
First Line : 89 SHARON ST
Second Line :
City : STOUGHTON
State : MA
Zip : 02072-2011
Country : US
Telephone Number : 781-344-3331
Fax Number : 781-344-4717
Authorized Official
Title or Position : OWNER
Name : DANIEL W THURM
Credential : OD
Telephone Number : 781-344-3331
Provider Enumeration Date : 10/11/2006
Last Update Date : 08/22/2020

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Directions to “COBB CORNER EYE CARE ” Practice Location

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