Organization
LOUDOUN EYE ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY PARK O.D. (OWNER)
(703) 724-0330
Entity
Organization
Contact information
Practice address
43480 YUKON DR, SUITE 214, ASHBURN, VA 20147-6984
(703) 724-0330
(703) 724-0811
Mailing address
43480 YUKON DR, SUITE 214, ASHBURN, VA 20147-6984
(703) 724-0330
(703) 724-0811
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001310
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010272815
—
VA
Enumeration date
05/29/2007
Last updated
04/19/2011
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