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General NPI Number Information
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NPI Number | 1285354696
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Entity Type | Individual
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Provider Name | VICKIE H SCHRAM
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Gender | Female
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 329 DELLBROOK LN
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City | INDEPENDENCE
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State | VA
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Zip | 24348-3705
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Country | US
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Telephone | 276-773-1861
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Fax |
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Provider Business Mailing Address
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Address Line | 590 MOUNTAIN VIEW DR
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City | WYTHEVILLE
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State | VA
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Zip | 24382-1222
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Country | US
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Telephone | 276-613-5264
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 0402003969
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License Number State | VA
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