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Individual

MS. STACY JEANNE NEWMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
124 COUNTRY CLUB CIR, WINCHESTER, VA 22602-6002
(540) 539-5475
Mailing address
124 COUNTRY CLUB CIR, WINCHESTER, VA 22602-6002
(540) 539-5475

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PGP-565821
VA

Other

Enumeration date
02/23/2011
Last updated
02/23/2011
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