| NPI | 1083151278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN WILLIAM DORAN O PT Ometrist 703-729-8007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002097) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |