Individual
SHADREKA L COLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2609 HUNTERS LN, BLAIRS, VA 24527-3019
(434) 429-8078
Mailing address
2609 HUNTERS LN, BLAIRS, VA 24527-3019
(434) 429-8078
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
11418530
VA
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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