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General NPI Number Information
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NPI Number | 1699904581
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Entity Type | Individual
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Provider Name | LINDSAY MARIE PETRIE O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2009
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Last Update Date | 06/04/2019
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Provider Practice Location Address
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Address Line | 30 CROSSING LN STE 107
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City | LEXINGTON
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State | VA
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Zip | 24450-6354
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Country | US
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Telephone | 540-463-9350
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Fax |
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Provider Business Mailing Address
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Address Line | 1039 CORNERSTONE PKWY
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City | ALLONS
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State | TN
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Zip | 38541-6858
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Country | US
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Telephone | 847-275-9404
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0618002742
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License Number State | VA
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