Individual
KEVIN H BRANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
230 WORCESTER ST, WELLESLEY, MA 02481-5420
(781) 431-5200
(781) 431-5298
Mailing address
147 MILK ST, PROVIDER ENROLLMENT DEPARTMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 421-2508
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1422
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1524747
—
MA
Enumeration date
04/25/2007
Last updated
07/08/2007
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