Kevin So O.D.

NPI 1710110390 - Optometrist - 152W00000X

NPI Details
NPI 1710110390
Gender Male
Enumeration Date 08/28/2009
Last Updated 09/22/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
91 S MAIN ST
WALLINGFORD CT, 06492-4203, US
Phone (203) 265-5152
Fax
Business Location
91 S MAIN ST
WALLINGFORD CT, 06492-4203, US
Phone
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Connecticut
License Number 2754
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According to our database, Kevin So O.D. NPI is 1710110390, taxonomy code is 152W00000X and license number is 2754, license state is located at Connecticut. Kevin So O.D. physically located at 91 S Main St, Wallingford CT, 06492-4203. NPI Number Kevin So O.D. has the Individual type.

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1710110390 NPI number is provided on an as is basis without warranty of any kind. 1710110390 is maintained by the National Plan & Provider Enumeration System. The contents of Kevin So O.D. are for informational purposes only.