Individual
PENNY MARLENE ALTIZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
124 RAYWOOD DR, NORTH TAZEWELL, VA 24630-9237
(276) 971-1992
Mailing address
PO BOX 399, NORTH TAZEWELL, VA 24630-0399
(276) 971-1992
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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