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Individual

MRS. GRACE A ODALLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3441 RAYTEE DR, CHESAPEAKE, VA 23323-1230
(757) 372-1912
Mailing address
3441 RAYTEE DR, CHESAPEAKE, VA 23323-1230
(757) 372-1912

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
0024178802
VA

Other

Enumeration date
07/30/2020
Last updated
07/30/2020
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