Healthcare Provider Details

I. General information

NPI: 1326359183
Provider Name (Legal Business Name): MOLLY FRANCES QUINN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2010
Last Update Date: 06/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8359 LEESBURG PIKE
VIENNA VA
22182-2492
US

IV. Provider business mailing address

8359 LEESBURG PIKE
VIENNA VA
22182-2492
US

V. Phone/Fax

Practice location:
  • Phone: 703-442-9295
  • Fax:
Mailing address:
  • Phone: 703-442-9295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618001948
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: