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General NPI Number Information
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NPI Number | 1942633466
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Entity Type | Organization
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Legal Business Name | DIGITAL ONE ENTERPRISES INC.
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 5521 FORT AVE
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City | LYNCHBURG
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State | VA
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Zip | 24502-5317
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Country | US
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Telephone | 434-509-1515
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Fax | 434-239-2006
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Provider Business Mailing Address
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Address Line | 5521 FORT AVE
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City | LYNCHBURG
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State | VA
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Zip | 24502-5317
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Country | US
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Telephone | 434-509-1515
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Fax | 434-239-2006
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Authorized Official
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Title or Position | CEO
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Name | MR. MARK WALTER LINDY
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Credential | CEO
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Telephone | 434-509-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 22321
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License Number State | VA
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