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Individual

MRS. BERNADETTE TISDALE COOK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2022 POOR HOUSE ROAD, LAWRENCEVILLE, VA 23868
(434) 247-1749
Mailing address
2022 POOR HOUSE RD, LAWRENCEVILLE, VA 23868-2712
(434) 247-1749

Taxonomy

Speciality
Code
Description
License number
State
171WV0202X
Vehicle Modifications Contractor
Primary

Other

Enumeration date
07/07/2017
Last updated
07/21/2022
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