Individual
LEADY DALLAN COLLAZOS QUIROGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTOMETRIST
Contact information
Practice address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(504) 432-4692
(703) 923-5043
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(504) 432-4692
(703) 923-5043
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
152W00000X
NC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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