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General NPI Number Information
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NPI Number | 1629934732
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Entity Type | Individual
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Provider Name | TROY JEFFERSON
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Gender | Male
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Dates
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Enumeration Date | 01/02/2026
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 2348 W SUNRISE DR
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City | DRY FORK
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State | VA
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Zip | 24549-2046
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Country | US
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Telephone | 434-228-6756
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Fax |
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Provider Business Mailing Address
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Address Line | 2348 W SUNRISE DR
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City | DRY FORK
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State | VA
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Zip | 24549-2046
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Country | US
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Telephone | 434-228-6756
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | VA
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