Individual
JACQUELINE ROSE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
289 MOODY ST, WALTHAM, MA 02453-5284
(781) 894-2127
Mailing address
22 SUNNYHILL RD, LUNENBURG, MA 01462-1331
(978) 870-2770
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5620
MA
Other
Enumeration date
05/23/2023
Last updated
08/22/2023
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