| NPI | 1568612190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA VU KELLY Optometrist/ Member 703-813-8997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 1104014455) |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2020-01-08 |