Lake Ridge Vision Center, INC

NPI #1508953431 in Woodbridge, Virginia

Provider Information

NPI Number: 1508953431
Entity Type: Organization
Organization Name: Lake Ridge Vision Center, INC
Primary Specialty: Optometrist
Enumeration Date: Oct 10, 2006
Last Updated: Apr 22, 2008

Practice Location

Address: 12444 DILLINGHAM SQ
City: Woodbridge
State: Virginia
ZIP Code: 22192-5258
Phone: (703) 680-4323

Authorized Official

Name: DR. DIANE MARY CONNESS, O.D.
Title: GENERAL PARTNER
Phone: (703) 680-4323

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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