Individual
DR. LAICE LANETTE JEFFRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
23105 THREE NOTCH RD STE A, CALIFORNIA, MD 20619-2417
(301) 863-2020
(301) 863-2417
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(866) 795-4020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA1454
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25101
SPECTERA
MD
01
—
36787
AVESIS
MD
Enumeration date
09/13/2006
Last updated
11/02/2023
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