Individual
MARIO POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
161 WASHINGTON ST., HAVERHILL, MA 01832-5418
(978) 912-7466
Mailing address
161 WASHINGTON ST., HAVERHILL, MA 01832-5418
(978) 912-7466
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
6276
MA
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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