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Individual

JEFFREY BIRD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
40 ENON ST, BEVERLY, MA 01915-1168
(978) 922-5996
(978) 922-5997
Mailing address
40 ENON STREET, BEVERLY, MA 01915-1168
(978) 922-5996
(978) 922-5997

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1881
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
156FX18004
MA
Enumeration date
09/08/2014
Last updated
09/08/2014
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