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General NPI Number Information
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NPI Number | 1770812190
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Entity Type | Organization
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Legal Business Name | ARKEYE
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Dates
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Enumeration Date | 12/14/2009
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 300 A AVENUE BLDG 1605
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City | FORT LEE
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State | VA
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Zip | 23801
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Country | US
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Telephone | 256-737-9109
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Fax | 804-732-0516
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Provider Business Mailing Address
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Address Line | 300 A AVE BLDG 1605
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City | FORT LEE
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State | VA
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Zip | 23801-1520
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Country | US
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Telephone | 479-841-5902
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Fax | 804-732-0516
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LANCE DANIEL
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Credential | O.D.
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Telephone | 804-733-8274
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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 | 0618001611
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License Number State | VA
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