Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPT1012 | ME |
NPI | 1306406525 |
---|---|
Provider Name | Ms. Catherine A Gallagher |
First Address | Brunswick, ME 04011-3359 |
Second Address | Brunswick, ME 04011-3359 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2019 |
Last Update Date | 19/06/2019 |