Organization
EYESPIRE EYECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AJIBOLA OGUNNUSI OD (OWNER)
(703) 719-9110
Entity
Organization
Contact information
Practice address
6506 LOISDALE RD STE 102, SPRINGFIELD, VA 22150-1815
(703) 719-9110
Mailing address
6506 LOISDALE RD STE 102, SPRINGFIELD, VA 22150-1815
(703) 719-9110
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002195
VA
Other
Enumeration date
08/27/2014
Last updated
03/02/2015
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