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Organization
CREATIVE LACTATION
Active
Organization
CREATIVE LACTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA SYPOLT IBCLC, RLC (OWNER)
(540) 466-1797
Entity
Organization
Contact information
Practice address
17376 TEDLER CIR, ROUND HILL, VA 20141-2633
(540) 466-1797
Mailing address
17376 TEDLER CIR, ROUND HILL, VA 20141-2633
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Enumeration date
05/17/2017
Last updated
06/16/2018
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