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General NPI Number Information
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NPI Number | 1386033215
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Entity Type | Organization
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Legal Business Name | OLIVER OPTICIANS
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 50 S PICKETT ST 29
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City | ALEXANDRIA
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State | VA
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Zip | 22304-7207
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Country | US
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Telephone | 703-567-0314
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Fax | 703-567-0384
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Provider Business Mailing Address
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Address Line | 50 S PICKETT ST 29
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City | ALEXANDRIA
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State | VA
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Zip | 22304-7207
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Country | US
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Telephone | 703-567-0314
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Fax | 703-567-0384
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MERON TARESSA
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Credential | OFFICE MANAGER
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Telephone | 703-567-0314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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