| |
1825 Blackwood Dr Maidens VA 23102-2526 | |
(804) 205-0355 | |
Not Available |
Full Name | |
---|---|
Speciality | Occupational Therapist |
Location | 1825 Blackwood Dr, Maidens, Virginia |
Authorized Official Name and Position | Nikki D Stout (OWNER) |
Authorized Official Contact | 8042050355 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1825 Blackwood Dr Maidens VA 23102-2526 Ph: (804) 205-0355 | 1825 Blackwood Dr Maidens VA 23102-2526 Ph: (804) 205-0355 |
NPI Number | 1134943392 |
---|---|
Provider Enumeration Date | 11/13/2024 |
Last Update Date | 11/19/2024 |
Certification Date | 11/19/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134943392 | NPI | - | NPPES |