Individual
ROY H MITTMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1601 HUGUENOT RD, MIDLOTHIAN, VA 23113-2428
(804) 794-3937
(804) 794-9216
Mailing address
1601 HUGUENOT RD, MIDLOTHIAN, VA 23113-2428
(804) 794-3937
(804) 794-9216
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000405
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
356769
ANTHEM
VA
01
—
OP2564
EYEMED PROVIDER ID
VA
Enumeration date
11/14/2007
Last updated
03/23/2014
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