Individual
SHANNON MARIE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDO
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1149
Mailing address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1149
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6119
MA
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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