Healthcare Provider Details
I. General information
NPI: 1881608230
Provider Name (Legal Business Name): HOPE SNIVELY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/28/2006
Last Update Date: 12/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7263E ARLINGTON BLVD
FALLS CHURCH VA
22042-3219
US
IV. Provider business mailing address
11656 PLAZA AMERICA DR
RESTON VA
20190-4700
US
V. Phone/Fax
- Phone: 703-573-1200
- Fax: 703-573-1250
- Phone: 703-467-0359
- Fax: 703-467-9080
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 0618000519 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: