Individual
BARRY BERTOLASIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
1840 GATOR BLVD, BUILDING 3841, VIRGINIA BEACH, VA 23459-8931
(757) 763-3321
Mailing address
835 CRASHAW ST, VIRGINIA BEACH, VA 23462-6913
(757) 288-5747
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
10/10/2013
Last updated
10/10/2013
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