Woodlake Village Pediatrics Llc

NPI 1578681946 - Specialist - 174400000X

NPI Details
NPI 1578681946
Enumeration Date 03/26/2007
Last Updated 05/22/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JENNIFER DIANE JENNIFER
Position OWNER
Phone (804) 639-0717
Fax (804) 639-0767
Practice Location
14732 VILLAGE SQUARE PL
MIDLOTHIAN VA, 23112-2253, US
Phone (804) 639-0717
Fax (804) 639-0767
Business Location
14732 VILLAGE SQUARE PLACE
MIDLOTHIAN VA, 23112-2253, US
Phone (804) 639-0717
Fax (804) 639-0767
Toxanomy
Taxonomy Code 174400000X
License State Virginia
License Number 0101056329
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According to our database, Woodlake Village Pediatrics Llc NPI is 1578681946, taxonomy code is 174400000X and license number is 0101056329, license state is located at Virginia. Woodlake Village Pediatrics Llc physically located at 14732 Village Square Pl, Midlothian VA, 23112-2253. NPI Number 1033115704 has the healthcare provider type.

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1578681946 NPI number is provided on an as is basis without warranty of any kind. 1578681946 is maintained by the National Plan & Provider Enumeration System. The contents of Woodlake Village Pediatrics Llc are for informational purposes only.