Organization
PETERSBURG FAMILY EYE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA L TESTAMARK O.D. (DOCTOR)
(804) 898-3373
Entity
Organization
Contact information
Practice address
44 MEDICAL PARK BLVD, STE H, PETERSBURG, VA 23805-9349
(804) 898-3373
(804) 479-3775
Mailing address
44 MEDICAL PARK BLVD, STE H, PETERSBURG, VA 23805-9349
(804) 898-3373
(804) 479-3775
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000693
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010315891
—
VA
Enumeration date
06/14/2007
Last updated
09/22/2015
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