Individual
TIMOTHY WILKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3235 GORDON DR, PETERSBURG, VA 23805-2658
(804) 989-2230
(804) 862-1805
Mailing address
PO BOX 1913, PETERSBURG, VA 23805-0913
(804) 892-2304
(804) 862-1508
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
347C0000X
VA
Other
Enumeration date
04/29/2015
Last updated
04/29/2015
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