Organization
EDMONDS OPTICIAN OF MCLEAN INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL G. TATE (PRESIDENT)
(703) 790-0377
Entity
Organization
Contact information
Practice address
6832 OLD DOMINION DR, MCLEAN, VA 22101-3887
(703) 790-0377
(703) 790-8594
Mailing address
6832 OLD DOMINION DR, MCLEAN, VA 22101-3887
(703) 790-0377
(703) 790-8594
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
12/06/2006
Last updated
05/06/2008
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