Individual
MR. RONNELL MARKETTE LIGHTFOOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2231 MERLE ST, HENRICO, VA 23231-1965
(804) 497-0098
Mailing address
2231 MERLE ST, HENRICO, VA 23231-1965
(804) 497-0098
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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