Individual
IESHA BOULWARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9414 LAKELAND FELLS LN, LORTON, VA 22079-5016
(703) 371-7456
Mailing address
9414 LAKELAND FELLS LN, LORTON, VA 22079-5016
(703) 371-7456
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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