Organization
UNBRIDLED CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE SHEREE HOLLING-BROOKS (EXECUTIVE DIRECTOR)
(540) 719-2171
Entity
Organization
Contact information
Practice address
754 RIDGE MOUNTAIN DR, BOONES MILL, VA 24065-4724
(540) 719-2171
(540) 719-2172
Mailing address
PO BOX 157, BOONES MILL, VA 24065-0157
(540) 719-2171
(540) 719-2172
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
03/31/2009
Last updated
03/31/2009
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