Organization
GEORGE D. BERTHERMAN,O.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE D BERTHERMAN (PRESIDENT)
(401) 941-6221
Entity
Organization
Contact information
Practice address
1466 BROAD ST, PROVIDENCE, RI 02905-2836
(401) 941-6221
(401) 941-6227
Mailing address
1466 BROAD ST, PROVIDENCE, RI 02905-2836
(401) 941-6221
(401) 941-6227
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316072
—
RI
Enumeration date
02/22/2007
Last updated
09/30/2022
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