| NPI | 1063606796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED E GOLDBERG Doctor Of Optometry 703-893-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0603000099) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2009-01-21 |