Individual
DR. KURIAKOSE V. THEKKETHALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1508 K-V ROAD, VICTORIA, VA 23974
(434) 696-2165
Mailing address
PO BOX 70, VICTORIA, VA 23974-0070
(434) 696-2165
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101027212
VA
Other
Enumeration date
12/15/2008
Last updated
12/15/2008
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