Individual
BRIAN J MAWHINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1290 HOSPITAL DR, SUITE 5, ST JOHNSBURY, VT 05819-9239
(802) 748-8126
(802) 748-2208
Mailing address
1290 HOSPITAL DR, SUITE 5, SAINT JOHNSBURY, VT 05819-9205
(802) 748-8126
(802) 748-2208
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0300000333
VT
152W00000X
Optometrist
0770
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010971
—
VT
05
—
30353214
—
NH
Enumeration date
09/23/2005
Last updated
08/08/2016
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