Individual
MRS. CHI HAE KWAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1 WASHINGTON ST, SUITE 212, WELLESLEY, MA 02481-1711
(781) 237-6770
(617) 636-4866
Mailing address
46 S MAIN ST, NATICK, MA 01760-4920
(617) 216-5884
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4311
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0323438
—
MA
Enumeration date
04/20/2006
Last updated
07/08/2007
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