Individual
MS. MARY C AVERETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1600 WESTBROOK AVE, RICHMOND, VA 23227
(804) 264-6089
Mailing address
624-204 BRISTOL VILLAGE DR., MIDLOTHIAN, VA 23114
(804) 349-8331
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306001335
VA
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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