Individual
MR. MICHAEL S MCAVOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
235 QUEEN ST, SOUTHINGTON, CT 06489-1915
(860) 628-4711
Mailing address
45 BUNKER HILL, CANTON, CT 06019
(860) 693-8088
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1094
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004162301
—
CT
Enumeration date
10/17/2006
Last updated
05/07/2008
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