Provider Demographics
NPI:1548543416
Name:STROUPE, RHETT
Entity type:Individual
Prefix:
First Name:RHETT
Middle Name:
Last Name:STROUPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 BOYLSTON ST
Mailing Address - Street 2:STE 4340
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1741
Mailing Address - Country:US
Mailing Address - Phone:617-485-4472
Mailing Address - Fax:617-608-4456
Practice Address - Street 1:43 BOYLSTON ST
Practice Address - Street 2:STE 4340
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-1741
Practice Address - Country:US
Practice Address - Phone:617-485-4472
Practice Address - Fax:617-608-4456
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5109152W00000X
DCOP1000395152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist