Individual
ANDREW M DEGROAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4420 TWILIGHT LN, SPOTSYLVANIA, VA 22551-3004
(540) 455-0064
Mailing address
PO BOX 2030, SPOTSYLVANIA, VA 22553-6804
(540) 455-0064
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-4616173
IRS
VA
Enumeration date
11/29/2019
Last updated
12/19/2019
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