Individual
JISOO SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
709 PINE ST, HERNDON, VA 20170-4604
(703) 471-7810
(703) 471-6549
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618003230
VA
152W00000X
Optometrist
OPC6222
FL
Other
Enumeration date
03/03/2023
Last updated
11/25/2025
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