Individual
MR. JOHN J SHUMATE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, CSAC
Contact information
Practice address
9609 JEFFERSON DAVIS HWY, NORTH CHESTERFIELD, VA 23237-4621
(804) 275-1116
Mailing address
922 W SOUTH BLVD, PETERSBURG, VA 23805-1924
(804) 835-2306
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710102653
VA
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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