Organization
OLIVET MEDICAL MINISTRY
Active
Other names
Lackey Free Family Medicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT BRADLEY JR. SOCIAL WORKER (EXECUTIVE DIRECTOR)
(757) 886-0608
Entity
Organization
Contact information
Practice address
1620 OLD WILLIAMSBURG RD, YORKTOWN, VA 23690-3910
(757) 886-0608
(757) 369-3821
Mailing address
1620 OLD WILLIAMSBURG RD, YORKTOWN, VA 23690-3910
(757) 886-0608
(757) 369-3821
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0024164154
VA
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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