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Individual

MRS. IDIAN DAMARA HALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2601 C AVE BLDG 8204, FORT GREGG ADAMS, VA 23801-1717
(804) 734-9212
Mailing address
2601 C AVE BLDG 8204, FORT GREGG ADAMS, VA 23801-1717
(804) 734-9212

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
05/25/2023
Last updated
05/25/2023
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