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Individual

MRS. KATHRYN ROSE EAGLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LDO

Contact information

Practice address
166 TINKERVILLE RD, GLASGOW, VA 24555-2962
(540) 291-3373
(540) 291-3373
Mailing address
166 TINKERVILLE RD, GLASGOW, VA 24555-2962
(540) 291-3373
(540) 291-3373

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1101003356
VA

Other

Enumeration date
01/16/2008
Last updated
01/16/2008
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