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Individual

KASSIDY IRBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 575-5864
Mailing address
2204 WILBORN AVE, SOUTH BOSTON, VA 24592-1645
(434) 575-5864

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
08/05/2024
Last updated
08/22/2024
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