Individual
DERRICK LAMONT CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
145 NEW INGRAM RD APT B, DANVILLE, VA 24541-5156
(434) 713-6375
Mailing address
145 NEW INGRAM RD APT B, DANVILLE, VA 24541-5156
(434) 713-6375
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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