Individual
REBECCA LYNNE KIVLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3031 JAVIER RD STE 300, FAIRFAX, VA 22031-4638
(703) 698-8880
(703) 698-8884
Mailing address
3031 JAVIER RD STE 300, FAIRFAX, VA 22031-4638
(703) 698-8880
(703) 698-8884
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618002728
VA
152W00000X
Optometrist
2963
CT
Other
Enumeration date
10/27/2015
Last updated
02/26/2019
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