Individual
DR. TRACEY J SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4588 VIRGINIA BEACH BLVD, CARE OF SEARS OPTICAL, VIRGINIA BEACH, VA 23462-3004
(757) 456-5550
(757) 456-5550
Mailing address
705 ERIK PAUL DR, CHESAPEAKE, VA 23322-3717
(757) 456-5550
(757) 456-0091
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000633
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457371502
—
VA
Enumeration date
07/20/2006
Last updated
07/14/2008
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