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General NPI Number Information
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NPI Number | 1649606781
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Entity Type | Organization
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Legal Business Name | WOMEN'S OSTEOPATHIC MEDICAL CARE, PLLC
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Dates
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Enumeration Date | 09/20/2013
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Last Update Date | 09/20/2013
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Provider Practice Location Address
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Address Line | 110 4TH ST
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City | FARMVILLE
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State | VA
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Zip | 23901-1319
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Country | US
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Telephone | 434-392-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 1692 PERSIMMON TREE FORK RD
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City | FARMVILLE
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State | VA
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Zip | 23901-2962
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Country | US
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Telephone | 434-392-9200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIANE MARY ASLANIS
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Credential | DO
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Telephone | 434-392-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 0102202679
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License Number State | VA
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