Healthcare Provider Details

I. General information

NPI: 1891132312
Provider Name (Legal Business Name): KATHERINE R. SEE O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2013
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5076 S AMHERST HWY
MADISON HEIGHTS VA
24572-2491
US

IV. Provider business mailing address

5076 S AMHERST HWY
MADISON HEIGHTS VA
24572-2491
US

V. Phone/Fax

Practice location:
  • Phone: 434-846-7822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618002230
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: