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General NPI Number Information
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NPI Number | 1285764589
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Entity Type | Organization
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Legal Business Name | VIRGINIA EYECARE ASSOCIATES PC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | 723 SOUTHPARK BLVD SUITE E
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City | COLONIAL HEIGHTS
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State | VA
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Zip | 23834
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Country | US
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Telephone | 804-559-1063
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Fax |
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Provider Business Mailing Address
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Address Line | 8056 PEBBLE PATH PKWY
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City | MECHANICSVILLE
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State | VA
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Zip | 23111
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Country | US
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Telephone | 804-559-1063
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | LISA D MOZEE
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Credential | OD
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Telephone | 804-526-4261
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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 | 0618000508
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License Number State | VA
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