Boston Ocular Prosthetics INC
Anaplastologist in Portland, ME. Organization (NPI-2).
NPI number1982106548
StatusActive
Last updated in NPPESMay 6, 2020
Details
- NPI
- 1982106548
- Entity type
- Organization (NPI-2)
- Legal business name
- Boston Ocular Prosthetics INC
- Organization subpart
- No
- Enumeration date
- Feb 28, 2018
- Certification date
- May 6, 2020
- Last updated
- May 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 229N00000X | Anaplastologist | – | – | Yes |
| 156FX1700X | Technician/Technologist, Ocularist | – | – |
Practice location
15 Lowell StPortland, ME 04102-2726
Phone 800-824-2492 · Fax 877-824-2413
Mailing address
Po Box 245Searsport, ME 04974-0245
Phone 800-824-2492 · Fax 877-824-2413
Authorized official
Kaylee Lizabeth Dougherty
President
8008242492
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