Individual
MRS. DIANNE MILLER MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
181 BLAIRS CT LOT 46, BLAIRS, VA 24527-2305
(434) 728-6176
(434) 228-4096
Mailing address
181 BLAIRS CT LOT 46, BLAIRS, VA 24527-2305
(434) 728-6176
(434) 228-4096
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T60213383
VA
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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