Individual
JENNA MICHELLE WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
19 VILLAGE SQ, CHELMSFORD, MA 01824-2712
(978) 256-5600
(978) 703-0250
Mailing address
19 VILLAGE SQ, CHELMSFORD, MA 01824-2712
(978) 256-5600
(978) 703-0250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5166
MA
152W00000X
Optometrist
OEG003049
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110116574A
—
MA
Enumeration date
07/09/2015
Last updated
12/15/2016
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