Individual
TOMMY MIKAL AMAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1999 S MAIN ST, 303-C, BLACKSBURG, VA 24060-6634
(773) 818-9052
Mailing address
1999 S MAIN ST, 303-C, BLACKSBURG, VA 24060-6634
(773) 818-9052
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
343900000X
VA
Other
Enumeration date
04/04/2015
Last updated
04/27/2015
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