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Individual

MISS PATRICHA WILBY POWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4016 57TERR, VERO BEACH, FL 32966
(772) 501-3951
Mailing address
4016 57TH TER, VERO BEACH, FL 32966-1878
(772) 501-3951

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906914
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
685625
FL
Enumeration date
09/29/2017
Last updated
07/21/2022
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