Provider Demographics
NPI:1790023331
Name:JENNY ALSOP, OD PLLC
Entity Type:Organization
Organization Name:JENNY ALSOP, OD PLLC
Other - Org Name:MIDLOTHIAN OPTOMETRIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSOP
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:804-379-1872
Mailing Address - Street 1:1306 ALVERSER PLZ
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2604
Mailing Address - Country:US
Mailing Address - Phone:804-379-1872
Mailing Address - Fax:804-379-0772
Practice Address - Street 1:1306 ALVERSER PLZ
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2604
Practice Address - Country:US
Practice Address - Phone:804-379-1872
Practice Address - Fax:804-379-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001779152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty