Organization
OLIVET MEDICAL MINISTRY, INC
Active
Other names
LACKEY CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL SALE RN, MSN (EXECUTIVE DIRECTOR)
(757) 886-0608
Entity
Organization
Contact information
Practice address
1620 OLD WILLIAMSBURG RD, YORKTOWN, VA 23690-3910
(757) 886-0608
(757) 968-5022
Mailing address
1620 OLD WILLIAMSBURG RD, YORKTOWN, VA 23690-3910
(757) 886-0608
(757) 968-5022
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
0201003931
VA
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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