| NPI | 1477285963 |
|---|---|
| Doing Business As | FAIR LAKES OPTOMETRY |
| Entity Type | Organization |
| Authorized Contact | ANH TRAM NGUYEN Optometrist 571-435-4558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2022-06-24 |