Individual
DR. DOUGLAS KIESSLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
14139 POTOMAC MILLS ROAD, WOODBRIDGE, VA 20192-4644
(703) 490-7606
(703) 490-7824
Mailing address
2101 EAST JEFFERSON STREET, PPQA MEDICARE COMPLIANCE UNIT 6W ATTN THERESA BROOKS, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0601000665
VA
152W00000X
Optometrist
Primary
0618000219
VA
152W00000X
Optometrist
OP399
DC
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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