Individual
SHANNON MARIE ZOLLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4244 VIRGINIA AVE, COLLINSVILLE, VA 24078
(434) 385-5600
Mailing address
PO BOX 1290, FOREST, VA 24551-1290
(434) 385-5600
(434) 455-7172
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002827
CT
152W00000X
Optometrist
5912
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548491293
—
CT
01
—
C00681
PTAN
CT
Enumeration date
07/29/2009
Last updated
10/25/2019
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