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Individual

JULIA YVONNE RENTFROW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
330 FIR ST, GATE CITY, VA 24251-2761
(276) 690-5896
Mailing address
330 FIR ST, GATE CITY, VA 24251-2761
(276) 690-5896

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
T65013335
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5896
VA
Enumeration date
01/07/2019
Last updated
01/07/2019
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