Organization
FAIR LAKES OPTOMETRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANH NGUYEN OD (OPTOMETRIST)
(571) 435-4558
Entity
Organization
Contact information
Practice address
13047 FAIR LAKES SHOPPING CTR, FAIRFAX, VA 22033-5179
(703) 502-3090
Mailing address
12587 FAIR LAKES CIR # 502, FAIRFAX, VA 22033-3822
(703) 502-3090
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002149
VA
Other
Enumeration date
07/10/2017
Last updated
07/25/2017
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