Individual
REBECCA MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12715 WARWICK BLVD, SUITE V, NEWPORT NEWS, VA 23606-1800
(757) 930-0139
(757) 930-4132
Mailing address
12715 WARWICK BLVD, SUITE V, NEWPORT NEWS, VA 23606-1800
(757) 930-0139
(757) 930-4132
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
186930 2006
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9112979
—
VA
Enumeration date
05/23/2006
Last updated
12/03/2007
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