Individual
ANDREA TENNILLE FIZZANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 BERNARD RD, ROCKY MOUNT, VA 24151-6614
(540) 483-5138
Mailing address
1980 ANGLE PLANTATION RD, ROCKY MOUNT, VA 24151-5634
(276) 340-6345
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119005078
VA
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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