Organization
1ST. STICK MEDICAL DRAW STATION
Active
Other names
1st. Stick Medical
Organization subpart
No
Provider details
NPI number
Authorized official
TELLY LESHAN OWENS (CEO)
(804) 424-3260
Entity
Organization
Contact information
Practice address
1405 WESTOVER HILLS BLVD STE 1A, RICHMOND, VA 23225-3153
(804) 424-3260
(804) 424-3261
Mailing address
4331 BATHGATE RD, RICHMOND, VA 23234-3581
(804) 549-9115
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
246RP1900X
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306368907
—
VA
Enumeration date
08/22/2017
Last updated
09/22/2020
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