Individual
AMY F SCALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
243 CHARLES ST, BOSTON, MA 02114-3002
(617) 573-4196
Mailing address
243 CHARLES ST, BOSTON, MA 02114-3002
(617) 573-4196
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4222
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4222
MA LICENSE #
MA
Enumeration date
11/01/2006
Last updated
10/17/2013
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