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General NPI Number Information
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NPI Number | 1477016608
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Entity Type | Organization
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Legal Business Name | SKYLARK TESTING CENTER, LLC
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Dates
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Enumeration Date | 04/14/2019
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Last Update Date | 04/14/2019
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Provider Practice Location Address
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Address Line | 831 W DANVILLE ST
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City | SOUTH HILL
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State | VA
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Zip | 23970-3003
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Country | US
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Telephone | 434-433-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 831 W DANVILLE ST
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City | SOUTH HILL
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State | VA
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Zip | 23970-3003
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Country | US
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Telephone | 434-433-3003
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | HOPE PEZZUTI
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Credential | RPSGT
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Telephone | 434-433-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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