Healthcare Provider Details

I. General information

NPI: 1205664406
Provider Name (Legal Business Name): AMANDA MORRIS OD AND ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 CEDAR CREEK GRADE STE 100
WINCHESTER VA
22601-7100
US

IV. Provider business mailing address

905 CEDAR CREEK GRADE STE 100
WINCHESTER VA
22601-7100
US

V. Phone/Fax

Practice location:
  • Phone: 540-665-0541
  • Fax: 540-665-8286
Mailing address:
  • Phone: 540-665-0541
  • Fax: 540-665-8286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. AMANDA MORRIS
Title or Position: OWNER
Credential: OD
Phone: 540-665-0541