Organization
AMAZING STAR HOMES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID O ETUTE (PRES/CEO)
(757) 819-3230
Entity
Organization
Contact information
Practice address
861 GLENROCK RD, SUITE 114, NORFOLK, VA 23502-3720
(757) 819-3230
(757) 893-9266
Mailing address
861 GLENROCK RD, SUITE 114, NORFOLK, VA 23502-3720
(757) 819-3230
(757) 893-9266
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0001120196
VA
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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