Individual
EDWARD TUBBERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4453
(540) 741-9200
(540) 741-9201
Mailing address
530 W NEW HOPE RD APT C1, GOLDSBORO, NC 27534-7586
(321) 525-2741
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/21/2024
Last updated
05/14/2025
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