Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 0618000176 | VA |
NPI | 1164442653 |
---|---|
Provider Name | Dr. Margaret Johnston |
First Address | Mclean, VA 22101-2723 |
Second Address | Alexandria, VA 22314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 19/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T31174 | (02) | VA |