Individual
AMINA AZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
260 MAPLE AVE E, VIENNA, VA 22180-4629
(703) 255-1502
Mailing address
260 MAPLE AVE E, VIENNA, VA 22180-4629
(703) 255-1502
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618003269
VA
Other
Enumeration date
06/05/2023
Last updated
05/19/2025
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