Organization
COUNTRYSIDE OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANCISCO ALTAMIRANO DO (PRESIDENT)
(703) 444-8500
Entity
Organization
Contact information
Practice address
20 PIDGEON HILL DR, SUITE 107, STERLING, VA 20165-6154
(703) 444-8500
(703) 406-3801
Mailing address
20 PIDGEON HILL DR, SUITE 107, STERLING, VA 20165-6154
(703) 444-8500
(703) 406-3801
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1101-001527
VA
Other
Enumeration date
06/13/2006
Last updated
08/22/2020
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