Organization
ENVISION OPTOMETRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA ROSE (OWNER)
(617) 426-0100
Entity
Organization
Contact information
Practice address
126 HIGH ST, BOSTON, MA 02110-2700
(617) 426-0100
Mailing address
126 HIGH ST, BOSTON, MA 02110-2700
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4792
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020970
PTAN
MA
Enumeration date
01/05/2015
Last updated
01/05/2015
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