Individual
MR. GREGORY LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
10299 WOODMAN RD, GLEN ALLEN, VA 23060-4419
(804) 727-8500
(804) 727-8580
Mailing address
10299 WOODMAN RD, GLEN ALLEN, VA 23060-4419
(804) 727-8628
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001237550
VA
Other
Enumeration date
01/19/2016
Last updated
05/18/2021
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