Individual
LYDIA PRATHER BALLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
8575 MAGELLAN PKWY STE 1000, RICHMOND, VA 23227-1164
(804) 229-2352
Mailing address
8575 MAGELLAN PKWY STE 1000, RICHMOND, VA 23227-1164
(804) 229-2352
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
02020009271
VA
Other
Enumeration date
04/10/2019
Last updated
04/10/2019
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