Individual
DR. MARK D. LIVADITIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5250 PORT ROYAL RD # G, SPRINGFIELD, VA 22151-2117
(703) 321-7780
(703) 321-2205
Mailing address
5250 PORT ROYAL RD # G, SPRINGFIELD, VA 22151-2117
(703) 321-7780
(703) 321-2205
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000747
VA
Other
Enumeration date
02/20/2007
Last updated
10/16/2009
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