Individual
LISA RENEE' ELMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30510 JEB STUART HWY, SPENCER, VA 24165-3585
(434) 822-3119
Mailing address
28 RAINBOW DR, COLLINSVILLE, VA 24078-2637
(434) 822-3119
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
VA
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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