Individual
DANIELLE NICOLE LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
582 BLUE RIDGE AVE, BEDFORD, VA 24523-2604
(540) 425-7910
Mailing address
205 WELLINGTON RD, SUMMERVILLE, SC 29485-5146
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110011717
VA
Other
Enumeration date
02/06/2026
Last updated
02/06/2026
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