Organization
EYE STREET OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN BERG FRITZKE OPTICIAN (OPTICIAN OWNER)
(703) 830-6377
Entity
Organization
Contact information
Practice address
3910 CENTREVILLE RD, SUITE 100, CHANTILLY, VA 20151-3279
(703) 830-6377
(703) 263-0326
Mailing address
3910 CENTREVILLE RD, SUITE 100, CHANTILLY, VA 20151-3279
(703) 830-6377
(703) 263-0326
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1101 000766
VA
Other
Enumeration date
06/01/2007
Last updated
10/08/2008
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