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General NPI Number Information
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NPI Number | 1295348647
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Entity Type | Organization
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Legal Business Name | MED-TECH MEDICAL MANAGEMENT LLC
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 1905 HUGUENOT RD STE 302
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4312
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Country | US
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Telephone | 804-406-7445
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Fax |
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Provider Business Mailing Address
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Address Line | 6804 GRAND BROOK CT
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City | RICHMOND
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State | VA
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Zip | 23225-4158
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Country | US
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Telephone | 804-406-7445
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS VALARIE LEE
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Credential |
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Telephone | 804-406-7445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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