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General NPI Number Information
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NPI Number | 1043297286
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Entity Type | Individual
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Provider Name | FRANK P LOIERCIO L.D.O.C.
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Gender | Male
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 281 INDEPENDENCE BLVD PEMBROKE ONE #105
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-2986
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Country | US
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Telephone | 757-497-9575
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Fax | 757-497-1292
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Provider Business Mailing Address
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Address Line | 1045 SWAPSCOTT CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-6725
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Country | US
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Telephone | 757-426-9701
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 1101002639
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License Number State | VA
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