Individual
TISHA STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED PHLEBOTOMY
Contact information
Practice address
920 S MAIN ST STE E, BLACKSTONE, VA 23824-2648
(804) 721-0943
Mailing address
920 S MAIN ST STE E, BLACKSTONE, VA 23824-2648
(804) 721-0943
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
671228110014
VA
246RP1900X
Phlebotomy Technician
Primary
671228110014
VA
Other
Enumeration date
03/25/2021
Last updated
06/15/2021
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