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General NPI Number Information
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NPI Number | 1740594290
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Entity Type | Organization
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Legal Business Name | LUCY S. LEE, O.D., P.L.L.C.
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 07/27/2010
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Provider Practice Location Address
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Address Line | 19369 PROMENADE DR SUITE K102
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City | LANSDOWNE
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State | VA
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Zip | 20176-6501
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Country | US
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Telephone | 571-333-1250
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Fax | 571-333-1251
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Provider Business Mailing Address
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Address Line | 19369 PROMENADE DR SUITE K102
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City | LANSDOWNE
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State | VA
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Zip | 20176-6501
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Country | US
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Telephone | 571-333-1250
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Fax | 571-333-1251
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | MISS SHERRI SCHULTE
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Credential |
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Telephone | 571-333-1250
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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 | 0618001284
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License Number State | VA
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