Individual
TARARNCE DERAIL ELAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
491 RUSSELL SPRINGS DR, LYNCHBURG, VA 24501-7280
(434) 473-2262
Mailing address
491 RUSSELL SPRINGS DR, LYNCHBURG, VA 24501-7280
(434) 473-2262
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
T60711698
VA
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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