Organization
OUR SUMMER PLACE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZATERA A SPENCER (OWNER/ADMINISTRATOR)
(757) 966-9978
Entity
Organization
Contact information
Practice address
3511 BLAINE ST, PORTSMOUTH, VA 23703-3115
(757) 483-4880
(757) 483-1578
Mailing address
PO BOX 3221, PORTSMOUTH, VA 23701-0221
(757) 966-9978
(757) 488-1008
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
558
VA
Other
Enumeration date
08/19/2006
Last updated
06/23/2008
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