Individual
SAMUEL J NORTHINGTON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 W BANK ST, PETERSBURG, VA 23803-3279
(804) 731-5570
Mailing address
1742 S SYCAMORE ST, PETERSBURG, VA 23805-1627
(804) 731-5570
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701009784
VA
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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