Individual
KATHLEEN EYSENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
OLD DOMINION UNIVERSITY, WEBB CENTER STUDENT HEALTH CENTER, NORFOLK, VA 23529-0001
(757) 683-3132
Mailing address
OLD DOMINION UNIVERSITY, WEBB CENTER STUDENT HEALTH CENTER, NORFOLK, VA 23529-0001
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0110000121
VA
Other
Enumeration date
05/30/2012
Last updated
05/30/2012
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