Individual
MRS. PEOUVISAK PEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
151 MAIN ST, SUITE #10, SALEM, NH 03079-3109
(978) 275-9549
Mailing address
151 MAIN ST, SUITE #10, SALEM, NH 03079-3109
(978) 275-9549
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1224
NH
Other
Enumeration date
03/04/2009
Last updated
03/04/2009
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