Individual
DANIEL WAYNE VANSKYHAWK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
414 CONCORD RD, PORTSMOUTH, VA 23701-2231
(757) 537-3813
Mailing address
414 CONCORD RD, PORTSMOUTH, VA 23701-2231
(757) 537-3813
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
17101003X
VA
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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