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Individual

NICKOLAS R WILLETTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ABOC, NCLC, LDO

Contact information

Practice address
1502 LOCUST ST, FALL RIVER, MA 02723-2719
(774) 276-5703
(888) 492-9389
Mailing address
1502 LOCUST ST, FALL RIVER, MA 02723-2719
(774) 276-5703
(888) 492-9389

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6426
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
46-1793649
TID
Enumeration date
01/16/2015
Last updated
01/27/2015
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