Individual provider · NPI-1

Sherrie Dedelow

Technician/Technologist, Optician · Stafford, VA

NPI number1164280905
StatusActive
Last updated in NPPESMar 7, 2024

Details

NPI
1164280905
Entity type
Individual (NPI-1)
Name
Sherrie Dedelow
Sex
Female
Sole proprietor
No
Enumeration date
Mar 7, 2024
Certification date
Mar 7, 2024
Last updated
Mar 7, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, Optician1101004205VAYes

Practice location

217 Garrisonville Rd
Stafford, VA 22554-1527

Phone 540-720-9255

Mailing address

217 Garrisonville Rd
Stafford, VA 22554-1527

Phone 571-499-1813

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