Individual
MITRA MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1669 CARL D SILVER PKWY, FREDERICKSBURG, VA 22401-4934
(540) 548-2345
(540) 548-1222
Mailing address
1669 CARL D SILVER PKWY, FREDERICKSBURG, VA 22401-4934
(540) 548-2345
(540) 548-1222
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001099
VA
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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