Organization
WAL-DAV INCORPORATED
Active
Other names
Luxur-Eyes Optometric Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA G WALLACE-DAVIS OD (OWNER)
(757) 827-6612
Entity
Organization
Contact information
Practice address
1134 BIG BETHEL RD, HAMPTON, VA 23666-1906
(757) 827-6612
(757) 827-6296
Mailing address
1134 BIG BETHEL RD, HAMPTON, VA 23666-1906
(757) 827-6612
(757) 827-6296
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000303
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009232583
—
VA
Enumeration date
02/03/2007
Last updated
12/15/2011
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