Individual
BRYAN BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
456 MARSH DUCK WAY, VIRGINIA BEACH, VA 23451-6557
(757) 846-8575
Mailing address
456 MARSH DUCK WAY, VIRGINIA BEACH, VA 23451-6557
(757) 846-8575
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
VA
Other
Enumeration date
05/11/2006
Last updated
03/22/2017
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