Individual
WESLEY EDDINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OWNER
Contact information
Practice address
1308 GRAVENHURST CIR, VIRGINIA BEACH, VA 23464-8660
(423) 930-3978
(757) 965-9777
Mailing address
1308 GRAVENHURST CIR, VIRGINIA BEACH, VA 23464-8660
(757) 202-9863
(757) 965-9777
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
83751657
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5150
AMBULATORY
—
Enumeration date
09/19/2019
Last updated
09/19/2019
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