Jerry J Deola OD

NPI 1093709594 - Optometrist - 152W00000X

NPI Details
NPI 1093709594
Gender Male
Enumeration Date 09/12/2005
Last Updated 03/21/2014
Entity Type Individual
Active Over 11 years ago
Practice Location
4460 DALE BLVD
WOODBRIDGE VA, 22193-2534, US
Phone (703) 670-8085
Fax
Business Location
4460 DALE BLVD
WOODBRIDGE VA, 22193-2534, US
Phone (703) 670-8085
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Virginia
License Number 0601000801
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According to our database, Dr. Jerry J Deola OD NPI is 1093709594, taxonomy code is 152W00000X and license number is 0601000801, license state is located at Virginia. Jerry J Deola OD physically located at 4460 Dale Blvd, Woodbridge VA, 22193-2534. NPI Number Jerry J Deola OD has the Individual type.

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1093709594 NPI number is provided on an as is basis without warranty of any kind. 1093709594 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry J Deola OD are for informational purposes only.