Individual
MS. MICHELLE BLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED BRA FITTER
Contact information
Practice address
11533 BUSY STREET, MAILBOX #307, N. CHESTERFIELD, VA 23236
(804) 687-0772
(804) 464-1129
Mailing address
11533 BUSY STREET, MAILBOX #307, N. CHESTERFIELD, VA 23236
(804) 687-0772
(804) 464-1129
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00
—
VA
Enumeration date
02/20/2020
Last updated
02/20/2020
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