Individual
DR. LACEY JORDAN MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 584-4040
Mailing address
421 N MAIN ST, LEEDS, MA 01053-9764
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002867
CT
Other
Enumeration date
10/05/2012
Last updated
01/18/2019
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