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Individual

DEBRA J ALECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
3511 WESTERN BRANCH BLVD, PORTSMOUTH, VA 23707-3133
(757) 397-3668
(757) 397-5889
Mailing address
3511 WESTERN BRANCH BLVD, PORTSMOUTH, VA 23707-3133
(757) 397-3668

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000870
VA
213E00000X
Podiatrist
1119
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
54 1031782
FED TAX ID
VA
05
9332146
VA
Enumeration date
12/01/2005
Last updated
08/12/2015
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