Individual
KRISTINA M DEPHILIPPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
940 BELMONT ST, BROCKTON, MA 02301-5596
(774) 826-1106
Mailing address
140 KENRICK STREET, UNIT 27, BRIGHTON, MA 02135-3830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002633
PA
Other
Enumeration date
07/08/2012
Last updated
07/10/2012
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