Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 4828 | MA |
NPI | 1043512718 |
---|---|
Provider Name | Dr. Christen Jean Kenrick |
First Address | Peabody, MA 01960-7901 |
Second Address | Peabody, MA 01960-7901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2010 |
Last Update Date | 15/11/2017 |