| Judy Gourley, | |
|
2204 Wilborn Ave, South Boston, VA 24592-1645 | |
| (434) 517-3579 | |
| Not Available |
| Full Name | Judy Gourley |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 2204 Wilborn Ave, South Boston, Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740686047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 613615 (Virginia) | Primary |
| 133V00000X | Dietitian, Registered | LOOO602 (North Carolina) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Judy Gourley, 2204 Wilborn Ave, South Boston, VA 24592-1645 Ph: (434) 517-3579 | Judy Gourley, 2204 Wilborn Ave, South Boston, VA 24592-1645 Ph: (434) 517-3579 |
Lisa Caudle, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2204 Wilborn Ave, South Boston, VA 24592 Phone: 434-517-3435 | |
Mara Olivia Fiorio, RDN Dietitian Medicare: Medicare Enrolled Practice Location: 2204 Wilborn Ave, South Boston, VA 24592 Phone: 434-571-3579 | |
Mrs. Tamara Mahr Sanford, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2204 Wilborn Ave, South Boston, VA 24592 Phone: 434-517-3100 Fax: 434-517-3168 |