Individual
MS. PATRICIA ANN WILBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
121 BEN BOLT AVE, TAZEWELL, VA 24651-9703
(276) 988-2515
Mailing address
207 VALLEYVIEW ST, N TAZEWELL, VA 24630-9585
(276) 979-0446
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
23056001441
VA
Other
Enumeration date
02/06/2013
Last updated
02/06/2013
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