Individual
JACQUELINE JIANG FREDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5511 MERCHANTS VIEW SQ, HAYMARKET, VA 20169-5439
(703) 659-4430
(703) 659-4438
Mailing address
5511 MERCHANTS VIEW SQ, HAYMARKET, VA 20169-5439
(703) 659-4430
(703) 273-0239
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001433
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010129460
—
VA
Enumeration date
03/08/2006
Last updated
12/14/2023
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