Individual
MRS. TINA C GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
510 CUMBERLAND ST, EXECUTIVE PLAZA 4TH FL, BRISTOL, VA 24201
(276) 645-4758
(276) 669-9093
Mailing address
510 CUMBERLAND ST, EXECUTIVE PLAZA 4TH FL, BRISTOL, VA 24201
(276) 645-4758
(276) 669-9093
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002054425
VA
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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