Individual
STEVEN DWAYNE MIZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
606 BROAD ST, SOUTH BOSTON, VA 24592-3200
(434) 575-5200
(434) 575-5054
Mailing address
PO BOX 776, SOUTH BOSTON, VA 24592-0776
(434) 575-5200
(434) 575-5054
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255419164
—
VA
Enumeration date
10/24/2017
Last updated
10/24/2017
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