Individual
DEZARAY C PURNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRANIAL PROSTHESIS
Contact information
Practice address
3089 HULL ST, RICHMOND, VA 23224-3575
(804) 269-0168
Mailing address
3089 HULL ST, RICHMOND, VA 23224-3575
(804) 690-1682
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
1201143615
VA
Other
Enumeration date
02/28/2022
Last updated
02/28/2022
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