Healthcare Provider Details

I. General information

NPI: 1902564776
Provider Name (Legal Business Name): MRS. TERRY SMITH BATTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2404 NORTHUMBERLAND AVE STE A
RICHMOND VA
23220-1525
US

IV. Provider business mailing address

1712 RENARD TER
RICHMOND VA
23231-5255
US

V. Phone/Fax

Practice location:
  • Phone: 804-683-0519
  • Fax: 804-652-1519
Mailing address:
  • Phone: 804-683-0516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: