Individual
CARLISA ANTOINETTE CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1127 MARIONS TRL, HALIFAX, VA 24558-3129
(434) 579-4466
Mailing address
502 CARDINAL CT, SOUTH BOSTON, VA 24592-1758
(434) 446-5144
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
T62219932
VA
Other
Enumeration date
03/26/2019
Last updated
03/26/2019
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