Individual
ARVEYETTE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7104 MIDLOTHIAN TPKE, RICHMOND, VA 23225-5501
(804) 276-9014
Mailing address
724 N PARHAM RD, RICHMOND, VA 23229-7250
(804) 276-9014
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0601001456
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18226001
DAVIS VISION
VA
01
—
19476
AVESIS
VA
01
—
VA1456
EYEMED
VA
Enumeration date
03/20/2007
Last updated
07/08/2007
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