Individual
DR. KELLY L JOEDICKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3910 CENTREVILLE RD, #100, CHANTILLY, VA 20151-3279
(703) 830-6380
(703) 263-2441
Mailing address
3910 CENTREVILLE RD, #100, CHANTILLY, VA 20151-3279
(703) 830-6380
(703) 263-2441
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
0618000697
VA
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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