| NPI | 1124190251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JEFFREY DAVIDSON President 703-569-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618000035) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2009-09-23 |