Individual
REVA OTEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4964 THORNSPRING RD, PULASKI, VA 24301-7022
(540) 994-9598
Mailing address
4964 THORNSPRING RD, PULASKI, VA 24301-7022
(540) 994-9598
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
11029237
VA
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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