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Individual

MRS. THERISSA WARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
716 MAINSAIL DR, NEWPORT NEWS, VA 23608-4712
(757) 277-1167
Mailing address
716 MAINSAIL DR, NEWPORT NEWS, VA 23608-4712
(757) 277-1167

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
10/22/2018
Last updated
05/26/2023
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