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Individual

ZIMIYBELU BEYENE LAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7109 FERNWOOD ST APT 2324, HENRICO, VA 23228-4028
(804) 503-1250
Mailing address
7109 FERNWOOD ST APT 2324, HENRICO, VA 23228-4028
(804) 503-1250

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
L19691370
VA

Other

Enumeration date
07/01/2019
Last updated
07/01/2019
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