Organization
MARK D. LIVADITIS, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK D LIVADITIS O.D. (OWNER)
(703) 321-7780
Entity
Organization
Contact information
Practice address
5250 G PORT ROYAL RD, SPRINGFIELD, VA 22151-2117
(703) 321-7780
(703) 321-2205
Mailing address
5250 G PORT ROYAL RD, SPRINGFIELD, VA 22151-2117
(703) 321-7780
(703) 321-2205
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000747
VA
Other
Enumeration date
02/06/2009
Last updated
08/25/2009
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