Provider Demographics
NPI:1588441000
Name:GLOVER, ARIELLE REBECCA (LICENSED OPTICIAN)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:REBECCA
Last Name:GLOVER
Suffix:
Gender:F
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:ARIELLE
Other - Middle Name:REBECCA
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 ARMORY DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851-2452
Mailing Address - Country:US
Mailing Address - Phone:757-562-6598
Mailing Address - Fax:757-562-5985
Practice Address - Street 1:1500 ARMORY DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-2452
Practice Address - Country:US
Practice Address - Phone:757-562-6598
Practice Address - Fax:757-562-5985
Is Sole Proprietor?:No
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101004350156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician