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Individual

TERRENCE ANTHONY MAXWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
REGISTERED OPTICIAN

Contact information

Practice address
333 SCHOOL ST, SUITE 304, PAWTUCKET, RI 02860-5334
(401) 723-4910
Mailing address
333 SCHOOL ST, SUITE 304, PAWTUCKET, RI 02860-5334
(401) 723-4910

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
RI 191
RI

Other

Enumeration date
11/20/2008
Last updated
11/20/2008
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