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General NPI Number Information
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NPI Number | 1295358489
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Entity Type | Organization
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Legal Business Name | QUICK STICKS, LLC
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Dates
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Enumeration Date | 05/21/2020
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Last Update Date | 07/30/2022
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Provider Practice Location Address
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Address Line | 9900 WARWICK BLVD
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City | NEWPORT NEWS
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State | VA
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Zip | 23601-4250
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Country | US
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Telephone | 252-413-9427
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Fax | 757-872-2294
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Provider Business Mailing Address
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Address Line | 119 TARBORO ST
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City | ROCKY MOUNT
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State | NC
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Zip | 27801-5429
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Country | US
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Telephone | 252-413-9427
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Fax | 252-442-0869
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Authorized Official
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Title or Position | OWNER
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Name | SHATERICA SHICOLE LEE
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Credential |
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Telephone | 252-413-9427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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