Boston Ocular Prosthetics INC

NPI #1982106548 in Portland, Maine

Provider Information

NPI Number: 1982106548
Entity Type: Organization
Organization Name: Boston Ocular Prosthetics INC
Primary Specialty: Anaplastologist
Enumeration Date: Feb 28, 2018
Last Updated: May 6, 2020

Practice Location

Address: 15 LOWELL ST
City: Portland
State: Maine
ZIP Code: 04102-2726
Phone: (800) 824-2492

Authorized Official

Name: KAYLEE LIZABETH DOUGHERTY, BCO, CCA
Title: PRESIDENT
Phone: (800) 824-2492

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist - Ocularist — Ocularist	156FX1700X
Anaplastologist	229N00000X	Primary

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