Individual
RODERICK FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
625 PRICE HAIRSTON LANE, MARTINSVILLE, VA 24112-1793
(276) 336-5634
Mailing address
625 PRICE HAIRSTON LANE, MARTINSVILLE, VA 24112-1793
(276) 336-5634
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T63313780
VA
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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