Individual
DR. ROBERT MITCHELL THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1466 BROAD ST, PROVIDENCE, RI 02905-2836
(401) 941-6221
(401) 941-6227
Mailing address
506 FISH HILL RD, WEST GREENWICH, RI 02817-2209
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODTA00456
RI
Other
Enumeration date
05/02/2006
Last updated
09/19/2013
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