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General NPI Number Information
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NPI Number | 1700987237
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Entity Type | Organization
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Legal Business Name | VIRGINIA EYECARE CENTER, P.C.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 9314 OLD KEENE MILL RD STE A
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City | BURKE
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State | VA
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Zip | 22015-4284
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Country | US
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Telephone | 703-569-3131
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Fax | 703-451-9291
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Provider Business Mailing Address
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Address Line | 9314 OLD KEENE MILL RD STE A
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City | BURKE
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State | VA
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Zip | 22015-4284
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Country | US
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Telephone | 703-569-3131
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Fax | 703-451-9291
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | TIMOTHY LA FRENIERE
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Credential | OD
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Telephone | 703-569-3131
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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 | 0603000237
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License Number State | VA
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