Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Optician |
156FX1800X | 96[5] | Optician |
| NPI Number | 1558583781 |
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| LBN Legal business name | KENNETH E. PLOURD | ||||
| Authorized official | KENNETH PLOURD - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 05/03/2007 | ||||
| Last updated | 06/17/2008 - About 18 years ago | ||||
| Identifiers |
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