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General NPI Number Information
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NPI Number | 1205997764
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Entity Type | Organization
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Legal Business Name | DOUGLAS & VICTORIA M WEISS
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 10/25/2014
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Provider Practice Location Address
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Address Line | 5B CENTRE CT
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City | PALMYRA
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State | VA
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Zip | 22963-2329
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Country | US
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Telephone | 434-591-0262
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Fax | 434-591-0111
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Provider Business Mailing Address
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Address Line | 5B CENTRE CT
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City | PALMYRA
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State | VA
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Zip | 22963-2329
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Country | US
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Telephone | 434-591-0262
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Fax | 434-591-0111
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Authorized Official
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Title or Position | 50 PARTNER OWNER
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Name | DR. VICTORIA MOLNAR WEISS
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Credential | OD
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Telephone | 434-591-0262
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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 | 0618000628
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 0618000628
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 0618000665
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 0618000628
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618000665
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License Number State | VA
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