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Individual

CHAKA OTEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8032 AIRPORT RD, QUINTON, VA 23141
(804) 932-3992
Mailing address
8032 AIRPORT RD, QUINTON, VA 23141-2406
(804) 932-3992

Taxonomy

Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
127006018017
VA
Enumeration date
01/30/2014
Last updated
01/30/2014
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