Provider Demographics
NPI:1306802178
Name:LE, JULIE M (OD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:M
Last Name:LE
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:474 WEST STREET
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431
Mailing Address - Country:US
Mailing Address - Phone:603-352-7803
Mailing Address - Fax:603-358-6711
Practice Address - Street 1:161 JACKSON ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2103
Practice Address - Country:US
Practice Address - Phone:978-937-9700
Practice Address - Fax:978-221-6205
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2022-06-14
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Provider Licenses
StateLicense IDTaxonomies
MA5117152W00000X
NHNH0717152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30351596Medicaid
NH30351596Medicaid
NHRE635301Medicare PIN