Basic Information
| Provider Information | |||||||||
| NPI: | 1063145845 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOWERTER | ||||||||
| FirstName: | BRADLEY | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 129 WAVERLEY ST APT 2 | ||||||||
| Address2: | |||||||||
| City: | BELMONT | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024781967 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8458201324 | ||||||||
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| Practice Location | |||||||||
| Address1: | 31 BURLINGTON MALL RD | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018034138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7817448555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2022 | ||||||||
| LastUpdateDate: | 10/25/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 5545 | MA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.