Individual
DR. WAYNE KEN CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
229 BERKELEY ST, BOSTON, MA 02116-3724
(617) 247-0012
(508) 872-7091
Mailing address
229 BERKELEY ST, BOSTON, MA 02116-3724
(617) 247-0012
(508) 872-7091
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3419
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0354333
—
MA
Enumeration date
08/16/2005
Last updated
01/22/2010
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