DR. Jacquelyn Tyra, OD

NPI #1154896363 in Ashburn, Virginia

Provider Information

NPI Number: 1154896363
Entity Type: Individual
Name: DR. Jacquelyn Tyra, OD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Oct 4, 2018
Last Updated: May 23, 2023

Practice Location

Address: 43490 YUKON DR STE 200
City: Ashburn
State: Virginia
ZIP Code: 20147-7315
Phone: (703) 724-0330

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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