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Individual

DR. AMY KEOPRASEUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
997 MAIN ST, WATERTOWN, CT 06795-2914
(860) 274-7576
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(860) 274-7576

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
3.003229
CT
152W00000X
Optometrist
Primary
OPT-000395
CO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/24/2018
Last updated
02/07/2022
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