Organization
VIRGINIA LOVING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON NICOLE WILSON (CEO)
(904) 234-7960
Entity
Organization
Contact information
Practice address
8343 PRINCETON SQUARE BLVD E, APT 105, JACKSONVILLE, FL 32256-8389
(904) 234-7960
Mailing address
8343 PRINCETON SQUARE BLVD E, APT 105, JACKSONVILLE, FL 32256
(904) 234-7960
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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