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Individual

DEANNA FAY HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
212 ROACHS LN, DILLWYN, VA 23936-3075
(143) 431-5308
Mailing address
212 ROACHS LN, DILLWYN, VA 23936-3075
(434) 315-3084

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
842040380
VA
Enumeration date
09/17/2021
Last updated
09/17/2021
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