Individual
REGINALD RIDDICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 LANCER DR, PORTSMOUTH, VA 23701-2144
(757) 292-7507
Mailing address
611 LANCER DR, PORTSMOUTH, VA 23701-2144
(757) 292-7507
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
04/29/2019
Last updated
05/15/2019
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