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Organization

TREATMENT 1

Active
Parent organization
9995.003/FTA-2012-006-TPM-VTCL
Other names
ladybug/ yes
Organization subpart
Yes

Provider details

NPI number
Legal business name
9995.003/FTA-2012-006-TPM-VTCL
Authorized official
MS. TONDALAYO CARTER CERTIFICATION (HISTOLOGY ASSITANT/ SURVEY ATTENDAN)
(202) 390-8043
Entity
Organization

Contact information

Practice address
2431 25TH ST SE APT 1, WASHINGTON, DC 20020-3467
(202) 390-8043
Mailing address
2431 25TH ST SE APT 1, APO, AE 20002-0000
(202) 390-8043

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
FTA-2012-006-TPM-VTC
DC

Other

Enumeration date
11/29/2012
Last updated
11/29/2012
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