Organization
LEADER SIX, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NOLEN VERNOR BIVENS (PRESIDENT)
(571) 285-3412
Entity
Organization
Contact information
Practice address
12691 CATAWBA DR, WOODBRIDGE, VA 22192-6415
(571) 285-3412
(571) 285-3088
Mailing address
12691 CATAWBA DR, WOODBRIDGE, VA 22192-6415
(571) 285-3412
(571) 285-3088
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
14L25848
VA
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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