Individual
JAY LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8386 SUDLEY RD, MANASSAS, VA 20109-3428
(703) 368-5557
(703) 368-6522
Mailing address
14270 HOLLY GLEN CT, MANASSAS, VA 20112-7011
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001147
VA
Other
Enumeration date
03/29/2006
Last updated
10/18/2011
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