Organization
PODIATRY HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDNA HOLMES D.P.M. (OWNER)
(100) 000-0000
Entity
Organization
Contact information
Practice address
1567 ASPIN AVE, SUITE B, NORFOLK, VA 23502-1532
(757) 965-4765
(757) 965-4765
Mailing address
7750 OGDEN AVE, APT A, NORFOLK, VA 23505-2069
(100) 000-0000
(757) 965-4765
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
0103000695
VA
Other
Enumeration date
06/10/2016
Last updated
06/28/2016
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