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Organization

WGA EYE CARE GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WALTER POTAZNICK OD (OWNER)
(508) 880-9505
Entity
Organization

Contact information

Practice address
625 COUNTY ST, TAUNTON, MA 02780-3651
(508) 880-9505
Mailing address
625 COUNTY ST, TAUNTON, MA 02780-3651
(508) 880-9505

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2567
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA2567
EYE MED
MA
Enumeration date
03/10/2009
Last updated
03/10/2009
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