Individual
TEODORA BROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
131 JONES ST, APPOMATTOX, VA 24522
(434) 352-8235
(434) 352-5532
Mailing address
131 JONES ST, APPOMATTOX, VA 24522-9830
(434) 352-8235
(434) 352-5532
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101261264
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207Q00000X
FAMILY MEDICINE
VA
Enumeration date
06/25/2014
Last updated
08/14/2018
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