Individual
DACHENIQUA K HEART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3245 GREEN LAKES DR, VIRGINIA BEACH, VA 23452-4914
(757) 418-5029
Mailing address
3245 GREEN LAKES DR, VIRGINIA BEACH, VA 23452-4914
(757) 418-5029
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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