Individual
MRS. BRENDA L TIBBETTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
170 MAIN ST STE E, MONSON, MA 01057-1353
(413) 267-4200
(413) 267-4200
Mailing address
170 MAIN ST STE E, MONSON, MA 01057-1353
(413) 267-4200
(413) 267-4200
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
5499
MA
Other
Enumeration date
12/08/2010
Last updated
12/27/2010
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