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Individual

FATMATA LANDFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15170 BRAZIL CIR, WOODBRIDGE, VA 22193-5547
(703) 300-8167
Mailing address
15170 BRAZIL CIR, WOODBRIDGE, VA 22193-5547
(703) 300-8166

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-22693
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HCO-22683
COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH
VA
Enumeration date
01/29/2022
Last updated
01/29/2022
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