Individual
MICHAEL BLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1213 E CLAY ST, RICHMOND, VA 23298-5071
(804) 828-0996
Mailing address
121 W BROAD ST APT 406, RICHMOND, VA 23220-2152
(757) 817-8344
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/16/2025
Last updated
04/21/2025
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