Doctor Name: | LISA R TRAINOR |
NPI Number: | 1174894414 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D.O. |
License Number: | 4966 |
Business Practice Address: | 69 Uxbridge Rd Mendon, MA - 017561017 |
Business Phone Number: | 5086343596 |
Business Fax Number: | 5086343596 |
Mailing Address: | 69 Uxbridge Rd, MENDON |
State: | MA |
Postal Code: | 017561017 |
Phone Number: | 5086343596 |
Fax Number: | 5086343596 |
NPI Enumeration Date: | 01/18/2012 |
NPI Last Update Date: | 01/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 4966 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |