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Individual

MR. STEPHEN E KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
11866 RICHMOND HWY, APPOMATTOX, VA 24522-7995
(434) 352-9877
(434) 352-4321
Mailing address
PO BOX 99, APPOMATTOX, VA 24522-0099
(434) 352-9877
(434) 352-4321

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0102911010
VA
05
0102911432
VA
Enumeration date
08/16/2010
Last updated
08/16/2010
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