Healthcare Provider Details

I. General information

NPI: 1497904940
Provider Name (Legal Business Name): CAUSAL CENTRE FOR NATURAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 09/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 S INDEPENDENCE BLVD STE 111
VIRGINIA BEACH VA
23452-1129
US

IV. Provider business mailing address

485 S INDEPENDENCE BLVD STE 111
VIRGINIA BEACH VA
23452-1129
US

V. Phone/Fax

Practice location:
  • Phone: 757-216-8097
  • Fax: 757-216-8101
Mailing address:
  • Phone: 757-216-8097
  • Fax: 757-216-8101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CHARISSE BARKSDALE
Title or Position: DIRECTOR
Credential: DS.C., DNM, MHT.
Phone: 757-216-8097