Dr. Jerry J Deola, OD
Optometrist in Woodbridge, VA. Individual provider (NPI-1).
NPI number1093709594
StatusActive
Last updated in NPPESMar 21, 2014
Details
- NPI
- 1093709594
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jerry J Deola
- Credential
- OD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 12, 2005
- Last updated
- Mar 21, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 0601000801 | VA | Yes |
Practice location
4460 Dale BlvdWoodbridge, VA 22193-2534
Phone 703-670-8085
Mailing address
4460 Dale BlvdWoodbridge, VA 22193-2534
Phone 703-670-8085
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