Individual
MR. KEVIN J. CRENSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DISPENSING OPTICIAN
Contact information
Practice address
45 ATHOL ST, SPRINGFIELD, MA 01107
(413) 627-9290
Mailing address
45 ATHOL STREET, SPRINGFIELD, MA 01107
(413) 627-9290
Taxonomy
Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
5655
MA
156FX1800X
Optician
Primary
5655
MA
Other
Enumeration date
06/25/2009
Last updated
06/25/2009
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