Individual
GLEN ONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
243 CHARLES STREET, BOSTON, MA 02114
(617) 523-7900
Mailing address
243 CHARLES STREET, BOSTON, MA 02114
(617) 523-7900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5025
MA
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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