Individual
TIFFANY ANGIE KWON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2014 CALVARY CIR APT 201, CHARLOTTESVILLE, VA 22911-8469
(909) 569-9290
Mailing address
2014 CALVARY CIR APT 201, CHARLOTTESVILLE, VA 22911-8469
(909) 569-9290
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618002533
VA
152W00000X
Optometrist
Primary
TUV007421-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03179962
—
NY
Enumeration date
07/06/2009
Last updated
01/17/2017
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