Individual
DR. JACQUELINE MARIE THEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3721 WESTERRE PKWY STE B, RICHMOND, VA 23233-1332
(804) 387-2902
Mailing address
1001 E BYRD ST APT 6329, RICHMOND, VA 23219-4292
(804) 387-2902
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002840
VA
152W00000X
Optometrist
14703TLG
CA
Other
Enumeration date
07/15/2013
Last updated
07/24/2020
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