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Individual

GUY R ACKERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
21738 MAGNOLIA AVE, PETERSBURG, VA 23803-2212
(804) 524-9097
(804) 524-9097
Mailing address
21738 MAGNOLIA AVE, PETERSBURG, VA 23803-2212
(804) 524-9097
(804) 524-9097

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
2705089862
VA
171WH0202X
Home Modifications Contractor
Primary
2705089862
VA

Other

Enumeration date
06/11/2009
Last updated
06/11/2009
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