Provider Demographics
NPI:1992374318
Name:KILLIAN, MARY FRANCES (OD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:FRANCES
Last Name:KILLIAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:24 HOYTS WHARF RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1532
Mailing Address - Country:US
Mailing Address - Phone:978-877-1974
Mailing Address - Fax:
Practice Address - Street 1:24 HOYTS WHARF RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1532
Practice Address - Country:US
Practice Address - Phone:978-877-1974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist