Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | MA 3188 | MA |
NPI | 1003884230 |
---|---|
Provider Name | Dr. Lance Preston Schultz |
First Address | Framingham, MA 01702-8247 |
Second Address | Framingham, MA 01702-8247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0353299 | (05) | MA |