Healthcare Provider Details
I. General information
NPI: 1356999536
Provider Name (Legal Business Name): CATON MARIE SAVAGE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/30/2019
Last Update Date: 08/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13332 MIDLOTHIAN TPKE
MIDLOTHIAN VA
23113-4210
US
IV. Provider business mailing address
4900 COX RD STE 155
GLEN ALLEN VA
23060-6507
US
V. Phone/Fax
- Phone: 804-794-5598
- Fax: 804-378-1954
- Phone: 804-726-8571
- Fax: 804-726-8574
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: