Individual
JORDAN DAVIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
243 CHARLES ST, BOSTON, MA 02114
(617) 523-7900
Mailing address
25 MECHANIC ST, FOXBORO, MA 02035-2011
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5262
MA
Other
Enumeration date
05/24/2017
Last updated
08/09/2018
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