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Individual

LEGAITHER MICHELLE DALTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
123 LOUISE AVE, MARTINSVILLE, VA 24112-9219
(276) 340-9753
Mailing address
123 LOUISE AVE, MARTINSVILLE, VA 24112-9219
(276) 340-9753

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary

Other

Enumeration date
10/05/2017
Last updated
10/05/2017
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  • EDI platform