Organization
PROFESSIONAL PARENT CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH RYDELL OWENS (SECRETARY)
(757) 778-5787
Entity
Organization
Contact information
Practice address
317 N ROSEMONT RD, SUITE 103, VIRGINIA BEACH, VA 23452-3449
(757) 323-2865
(757) 962-4855
Mailing address
317 N ROSEMONT RD, SUITE 103, VIRGINIA BEACH, VA 23452-3449
(757) 323-2865
(757) 962-4855
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
S352074-1
VA
Other
Enumeration date
05/31/2011
Last updated
05/31/2011
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