Individual provider · Type 1 NPI

Leady Dallan Collazos Quiroga, OPTOMETRIST

Student in an Organized Health Care Education/Training Program · Vienna, VA

NPI number 1033917000 Active

Practice location

8614 Westwood Center Dr Fl 9
Vienna, VA 22182-2442

Call (504) 432-4692 Map

Fax (703) 923-5043

Specialties and licenses

TaxonomyCodeLicense
Optometrist 152W00000X152W00000X (NC)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1033917000

Leady Dallan Collazos Quiroga, OPTOMETRIST's National Provider Identifier is 1033917000, issued on Mar 5, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Vienna, VA. The record was last updated on Mar 5, 2025.