Individual
RANDY DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
911 MILL STREAM LN, LYNCHBURG, VA 24502-4222
(772) 925-9667
Mailing address
911 MILL STREAM LN, LYNCHBURG, VA 24502-4222
(772) 925-9667
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
2306601877
VA
Other
Enumeration date
08/16/2015
Last updated
08/16/2015
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