Healthcare Provider Details

I. General information

NPI: 1306298518
Provider Name (Legal Business Name): PATRICIA BARCLIFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 LONG SHORT RD
JAVA VA
24565-4601
US

IV. Provider business mailing address

301 LONG SHORT RD
JAVA VA
24565-4601
US

V. Phone/Fax

Practice location:
  • Phone: 434-770-5698
  • Fax: 434-836-8279
Mailing address:
  • Phone: 434-770-5698
  • Fax: 434-836-8279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: