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Individual

DOUGLAS DORITY MACLEOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
53 COURT ST, PLYMOUTH, MA 02360-3822
(508) 746-8880
(508) 746-5752
Mailing address
53 COURT ST, PLYMOUTH, MA 02360-3822
(508) 746-8880
(508) 746-5752

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
2044
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0280120001
PTAN
MA
05
110028513A
MA
Enumeration date
03/02/2007
Last updated
08/05/2015
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