Individual
MARCIA K LEVERETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
812 S LYNNHAVEN RD, SUITE 100, VIRGINIA BEACH, VA 23452-6313
(757) 486-2015
(757) 486-0853
Mailing address
812 S LYNNHAVEN RD, SUITE 100, VIRGINIA BEACH, VA 23452-6313
(757) 486-2015
(757) 486-0853
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000402
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578568283
PHYSICIAN NPI
VA
Enumeration date
06/17/2005
Last updated
06/23/2015
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