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General NPI Number Information
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NPI Number | 1447467881
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Entity Type | Organization
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Legal Business Name | DR. VOORTHUIS, O.D. AND ASSOCIATES, P.C.
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 530 KING ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-3104
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Country | US
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Telephone | 703-683-3822
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 NEW MEXICO AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20016-3622
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Country | US
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Telephone | 202-363-5087
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Fax | 202-363-5063
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. REBECCA CORINNE VOORTHUIS-GOLDMAN
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Credential | O.D.
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Telephone | 703-683-3822
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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 | 06018000927
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License Number State | VA
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