Individual
DR. JOHN T. DANIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1964 BOSTON RD, WILBRAHAM, MA 01095-1055
(413) 543-5444
(413) 543-5444
Mailing address
1964 BOSTON RD, WILBRAHAM, MA 01095-1055
(413) 543-5444
(413) 543-5444
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2602
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110014431A
—
MA
05
—
110014431B
—
MA
Enumeration date
06/10/2005
Last updated
05/14/2010
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