Individual
DR. KENDRA PHILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
930 COMMONWEALTH AVE, BOSTON, MA 02215-1274
(617) 262-2020
Mailing address
10 POLIQUIN DR, NASHUA, NH 03062-2264
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5352
MA
152WC0802X
Corneal and Contact Management Optometrist
5352
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/29/2019
Last updated
07/08/2020
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