Individual
DR. LAURA FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
9600 MAIN ST, SUITE H, FAIRFAX, VA 22031-3798
(703) 764-3937
(703) 764-3986
Mailing address
9600 MAIN ST, SUITE H, FAIRFAX, VA 22031-3798
(703) 764-3937
(703) 764-3986
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001477
VA
152W00000X
Optometrist
OPC3889
FL
152W00000X
Optometrist
TA1945
MD
Other
Enumeration date
07/06/2006
Last updated
01/26/2011
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