Individual
MR. MARLIN DALE WIITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9524 HOSPITAL AVE, NASSAWADOX, VA 23413-0077
(757) 442-6600
Mailing address
PO BOX 77, NASSAWADOX, VA 23413-0077
(757) 442-6600
(757) 442-3839
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110002793
VA
Other
Enumeration date
11/12/2008
Last updated
11/18/2009
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