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Individual

DONALD RAY FOWLER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
BSN-NURSING

Contact information

Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2849
(757) 953-2870
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2849
(757) 953-2870

Taxonomy

Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
0001080522
VA

Other

Enumeration date
02/14/2006
Last updated
07/08/2007
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