Individual
DR. PATRICIA CLUBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
10338 BRISTOW CENTER DR, BRISTOW, VA 20136-2201
(703) 392-1010
(703) 392-4975
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002576
VA
Other
Enumeration date
05/11/2017
Last updated
12/17/2021
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