Organization
DIADEM DOYENNE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JIMEKA L FITZGERALD (CEO)
(757) 977-6491
Entity
Organization
Contact information
Practice address
6515 PORTSMOUTH BLVD, PORTSMOUTH, VA 23701
(757) 977-6491
Mailing address
PO BOX 3707, PORTSMOUTH, VA 23701-0707
(757) 977-6491
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
224P00000X
Prosthetist
—
—
Other
Enumeration date
09/15/2017
Last updated
07/21/2022
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