Individual
MRS. MARY CHRISTINE BEAULIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
131 BOSTON POST RD, SUITE 4, WATERFORD, CT 06385-2839
(860) 442-5058
(860) 443-4118
Mailing address
131 BOSTON POST RD, SUITE 4, WATERFORD, CT 06385-2839
(860) 442-5058
(860) 443-4118
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2212
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004092277
—
CT
Enumeration date
12/05/2006
Last updated
08/26/2009
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