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General NPI Number Information
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NPI Number | 1093171225
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Entity Type | Organization
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Legal Business Name | MICHAEL G. KWOK, O.D. PLLC
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Dates
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Enumeration Date | 01/04/2016
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 440 SPOTSYLVANIA TOWNE CENTRE
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-1123
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Country | US
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Telephone | 540-786-2272
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Fax | 540-786-3793
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Provider Business Mailing Address
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Address Line | 8123 GILROY DR
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City | LORTON
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State | VA
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Zip | 22079-2937
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Country | US
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Telephone | 443-845-1188
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Fax |
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Authorized Official
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Title or Position | PRESIDENT / OPTOMETRIST
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Name | DR. MICHAEL G KWOK
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Credential | O.D.
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Telephone | 443-845-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State | VA
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