| NPI | 1538135637 |
|---|---|
| Former Legal Business Name | JACQUELINE JIANG FREDRICK, OD |
| Entity Type | Organization |
| Authorized Contact | JACQUELINE JIANG FREDRICK Owner 703-669-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618001433) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2020-08-22 |