Individual
MRS. GLADYS ELVINE FAULCON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1533 PALMYRA ST, NORFOLK, VA 23502-1529
(757) 961-8023
Mailing address
1533 PALMYRA ST, NORFOLK, VA 23502-1529
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
047803/F03461
VA
Other
Enumeration date
09/20/2007
Last updated
12/27/2007
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