Healthcare Provider Details
I. General information
NPI: 1508571381
Provider Name (Legal Business Name): S D AND B MEDICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2023
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH VA
23452-7332
US
IV. Provider business mailing address
780 LYNNHAVEN PKWY STE 400
VIRGINIA BEACH VA
23452-7332
US
V. Phone/Fax
- Phone: 757-615-7685
- Fax:
- Phone: 757-615-7685
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 224L00000X |
| Taxonomy | Pedorthist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVEN
C
FRANKLIN
Title or Position: OWNER
Credential: CERTIFIED PEDORTHIST
Phone: 757-615-7685