Individual
MRS. PATRINA RENEE WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 OLIVE BRANCH BLVD, GRIFTON, NC 28530
(804) 894-6108
Mailing address
203 OLIVE BRANCH BLVD, GRIFTON, NC 28530
(804) 894-6108
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
8700797
ND
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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