Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 5478 | MA |
NPI | 1063653608 |
---|---|
Provider Name | Ms. Paige Bauer Barrett |
First Address | Orleans, MA 02653 |
Second Address | Orleans, MA 02653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2009 |
Last Update Date | 31/10/2016 |