Individual
MYRON WASIUTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
15189 MONTANUS DR, CULPEPER, VA 22701-1679
(540) 825-8220
(540) 825-8675
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
0618000246
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9236066
—
VA
Enumeration date
01/10/2006
Last updated
01/25/2018
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