Individual
EBONY COSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 BOULDERS RD, CHARLOTTESVILLE, VA 22911
(434) 951-4747
Mailing address
6387 CENTER DR, SUITE 9, NORFOLK, VA 23502-4109
(757) 461-8820
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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