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Individual

JOHN DESHAIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
15 CENTRAL ST, ANDOVER, MA 01810-3758
(978) 475-5252
(978) 475-2226
Mailing address
15 CENTRAL ST, ANDOVER, MA 01810-3758
(978) 475-5252
(978) 475-2226

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5034
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA5034
MA LICENSE NUMBER
Enumeration date
08/12/2014
Last updated
08/12/2014
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