Organization
FIRE AND ICE RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HANNUM (OWNER)
(757) 254-1654
Entity
Organization
Contact information
Practice address
11838 CANON BLVD STE 100, NEWPORT NEWS, VA 23606-2592
(757) 272-1746
Mailing address
11838 CANON BLVD STE 100, NEWPORT NEWS, VA 23606-2592
(757) 272-1746
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
11/21/2023
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