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Individual

DR. MICHAEL C WELLINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
555 HUBBARD AVE, PITTSFIELD, MA 01201-3876
(413) 442-2848
Mailing address
22 TEMPLE ST, ADAMS, MA 01220-2105
(413) 743-4979

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2407
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0320676
MA
Enumeration date
08/24/2006
Last updated
07/08/2007
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