Individual
HENRY E WOODCOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
63 MAIN ST, BROCKTON NEIGHBORHOOD HEALTH CENTER, BROCKTON, MA 02301-4042
(508) 894-3503
(508) 559-5073
Mailing address
63 MAIN ST, ATTN: VIRGILIA PIRES, BROCKTON, MA 02301-4042
(508) 894-3503
(508) 559-5073
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2607
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026097302
UNIVERA # LTH
NY
01
—
101944CS
PREFERRED CARE # LTH
NY
01
—
P010003495
BLUE CHOICE # LTH
NY
Enumeration date
05/03/2006
Last updated
10/12/2016
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