Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 421718670 | VA |
NPI | 1275976326 |
---|---|
Provider Name | Mrs. Sheree L. Dandridge |
First Address | Martinsville, VA 24112-2720 |
Second Address | Martinsville, VA 24112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2013 |
Last Update Date | 06/04/2017 |