Provider Demographics
NPI:1972683779
Name:HARMON, WAYNE HOWARD (RDO)
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:HOWARD
Last Name:HARMON
Suffix:
Gender:M
Credentials:RDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 WORCESTER RD
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-5211
Mailing Address - Country:US
Mailing Address - Phone:508-370-3937
Mailing Address - Fax:508-370-3940
Practice Address - Street 1:945 WORCESTER RD
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-5211
Practice Address - Country:US
Practice Address - Phone:508-370-3937
Practice Address - Fax:508-370-3940
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1622156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician