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Individual

MS. GEORGETTE BAILEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
6047 HAVENVIEW DR, MECHANICSVILLE, VA 23111-7507
(434) 401-8077
Mailing address
6047 HAVENVIEW DR, MECHANICSVILLE, VA 23111-7507
(434) 401-8077

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
0119002770
VA

Other

Enumeration date
02/27/2012
Last updated
02/27/2012
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