Individual
EDSON LINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
311 SOMERVILLE AVE, SOMERVILLE, MA 02143-2914
(617) 776-6300
(617) 776-0404
Mailing address
311 SOMERVILLE AVE, SOMERVILLE, MA 02143-2914
Taxonomy
Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
5128
MA
156FC0801X
Contact Lens Fitter
Primary
5128
MA
156FX1700X
Ocularist
5128
MA
156FX1800X
Optician
5128
MA
Other
Enumeration date
02/18/2011
Last updated
02/18/2011
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