Individual
CARLOS D BRANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
426 WOODRUFF ST, SUFFOLK, VA 23434-3455
(757) 292-5878
Mailing address
426 WOODRUFF ST, SUFFOLK, VA 23434-3455
(757) 292-5878
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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