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General NPI Number Information
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NPI Number | 1669532644
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Entity Type | Organization
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Legal Business Name | VISUALEYES OPTOMETRISTS PLLC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 10/07/2010
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Provider Practice Location Address
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Address Line | 9600 MAIN ST STE H
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City | FAIRFAX
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State | VA
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Zip | 22031-3798
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Country | US
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Telephone | 703-764-3937
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Fax | 703-764-3986
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Provider Business Mailing Address
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Address Line | 9600 MAIN ST STE H
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City | FAIRFAX
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State | VA
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Zip | 22031-3798
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Country | US
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Telephone | 703-764-3937
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Fax | 703-764-3986
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERRI VO
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Credential | O.D.
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Telephone | 703-764-3937
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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 | 0618000709
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License Number State | VA
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