Provider Demographics
NPI:1750073383
Name:VIRE, BOBBI JO ELIZABETH (ABO CERTIFIED)
Entity type:Individual
Prefix:
First Name:BOBBI JO
Middle Name:ELIZABETH
Last Name:VIRE
Suffix:
Gender:F
Credentials:ABO CERTIFIED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BOWEN ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-2329
Mailing Address - Country:US
Mailing Address - Phone:603-543-1843
Mailing Address - Fax:603-543-1854
Practice Address - Street 1:14 BOWEN ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2329
Practice Address - Country:US
Practice Address - Phone:603-543-1843
Practice Address - Fax:603-543-1854
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH210250156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician