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Organization

INDEPENDANT LIFE STYLES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARRIE FRANCES WEEKS (GENERAL MANAGER/ OWNER)
(434) 846-7510
Entity
Organization

Contact information

Practice address
4880 S AMHERST HWY, MADISON HEIGHTS, VA 24572-2478
(434) 846-7510
(434) 846-7189
Mailing address
4880 S AMHERST HWY, MADISON HEIGHTS, VA 24572-2478
(434) 846-7510
(434) 846-7189

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009120645
VA
Enumeration date
06/04/2006
Last updated
11/04/2008
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