Individual
OTTIE M THOMAS-SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCO, CCA
Contact information
Practice address
780 BOYLSTON ST, BOSTON, MA 02199-7820
(617) 750-6273
Mailing address
404 MOOSEHEAD TRL, JACKSON, ME 04921-3314
(207) 722-3462
(207) 722-3320
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
Other
Enumeration date
12/02/2008
Last updated
05/31/2011
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