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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARQURITA ARLENE WADDLER (LPN)
(757) 339-3642
Entity
Organization

Contact information

Practice address
124 PRESTON AVE, PORTSMOUTH, VA 23707-4568
(757) 339-3642
Mailing address
124 PRESTON AVE, PORTSMOUTH, VA 23707-4568
(757) 339-3642

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
VA

Other

Enumeration date
02/06/2015
Last updated
02/06/2015
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