Individual
MARIANNE TANTOCO DAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2246 GEORGE WASHINGTON MEMORIAL HWY, HAYES, VA 23072-3559
(804) 642-6171
(804) 642-5656
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102203692
VA
Other
Enumeration date
07/31/2006
Last updated
01/10/2014
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