Individual
DR. THEANCHAI - TANLAMAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
215 NEWBURY ST, BOSTON, MA 02116-2518
(617) 437-1364
(617) 424-8070
Mailing address
215 NEWBURY ST, BOSTON, MA 02116-2518
(617) 437-1364
(617) 424-8070
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MA3258
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PN 0334481
—
MA
Enumeration date
02/06/2007
Last updated
07/08/2007
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