Individual
DERESE GELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15628 WILLIAM BAYLISS CT, WOODBRIDGE, VA 22191-6072
(571) 405-8974
Mailing address
15628 WILLIAM BAYLISS CT, WOODBRIDGE, VA 22191-6072
(571) 405-8974
Taxonomy
Speciality
Code
Description
License number
State
342000000X
Transportation Network Company
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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