Individual
MR. GEORGE CLIFTON AXTELL II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
12302 ROARINGBROOK CT, RICHMOND, VA 23233-2106
(804) 350-3211
Mailing address
1401 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
(804) 483-7760
Taxonomy
Speciality
Code
Description
License number
State
2279P3900X
Neonatal/Pediatric Registered Respiratory Therapist
Primary
117004682
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DXH7310
PERSONAL
—
Enumeration date
05/03/2020
Last updated
05/03/2020
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