Individual
SEONG KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
14001D SAINT GERMAIN DR, CENTREVILLE, VA 20121-2338
(703) 266-3991
(703) 266-3990
Mailing address
14001D SAINT GERMAIN DR, CENTREVILLE, VA 20121-2338
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1101003797
VA
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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