Individual
KEVIN SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
604 LAKEWOOD RD, WATERBURY, CT 06704-2419
(203) 575-0900
Mailing address
8614 WESTWOOD CENTER DR FL 9, VIENNA, VA 22182-2442
(703) 847-8899
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2754
CT
Other
Enumeration date
08/28/2009
Last updated
10/24/2024
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