Individual
KENNETH WITHERSPOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3900 PLANK RD, FREDERICKSBURG, VA 22407-6839
(540) 656-6325
Mailing address
PO BOX 5515, FREDERICKSBURG, VA 22403-0515
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
VA
Enumeration date
01/18/2022
Last updated
01/18/2022
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