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 code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 1101004205 | VA | Yes |
Practice location
217 Garrisonville RdStafford, VA 22554-1527
Phone 540-720-9255
Mailing address
217 Garrisonville RdStafford, VA 22554-1527
Phone 571-499-1813
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