Individual
QUANISHA MALLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
806 FORT HENRY ST, PETERSBURG, VA 23803-3021
(804) 712-6963
Mailing address
PO BOX 1002, PETERSBURG, VA 23804-1002
(804) 712-6963
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
07/02/2021
Last updated
07/02/2021
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