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Organization

MOA MID-ATLANTIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT M ALLEN OD (CEO / DOCTOR)
(703) 719-8811
Entity
Organization

Contact information

Practice address
3910 CENTREVILLE RD STE 102, CHANTILLY, VA 20151-3280
(703) 719-8811
(703) 263-2441
Mailing address
3910 CENTREVILLE RD STE 102, CHANTILLY, VA 20151-3280
(703) 719-8811
(703) 263-2441

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Enumeration date
11/10/2021
Last updated
11/10/2021
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