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Individual

DR. GLENNA ANNE WAITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
BJS OPTICAL, GLENNA WAITT OD, PLYMOUTH, MA 02360
(508) 732-0420
Mailing address
74 SURF AVE, MARSHFIELD, MA 02050-6746
(781) 834-2235

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2957
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2957
STATE LICENSE
MA
Enumeration date
02/12/2007
Last updated
08/10/2020
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