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Individual

TAWNY NICOLE BANVILLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
603 W PATRICK ST STE B, FREDERICK, MD 21701-4090
(301) 620-1414
Mailing address
119 VIRGINIA AVE, BERRYVILLE, VA 22611-1309
(540) 539-2007

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U03049
MD

Other

Enumeration date
10/17/2023
Last updated
10/17/2023
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