Individual
MRS. EVANGELETTE WILSON PANNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA/CWCA
Contact information
Practice address
71 VIKING DR, LYNCHBURG, VA 24502-4439
(434) 239-6060
Mailing address
71 VIKING DR, LYNCHBURG, VA 24502-4439
(434) 239-6060
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306001421
VA
Other
Enumeration date
08/28/2009
Last updated
08/28/2009
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