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Individual

SANDRA LUCILE PAINTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPHT

Contact information

Practice address
20 W BANK ST, SUITE 6, PETERSBURG, VA 23803-3279
(804) 862-8002
(804) 862-8023
Mailing address
5008 CALDWELL AVE, NORTH CHESTERFIELD, VA 23234-3910
(804) 862-8002
(804) 862-8023

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0230019120
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0230019120
STATE LICENSE
VA
Enumeration date
10/18/2011
Last updated
10/18/2011
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