Organization
KINGDOM DOMINION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY L WALKER (OWNER)
(804) 525-4345
Entity
Organization
Contact information
Practice address
633 NEWTON ST, DANVILLE, VA 24541-2019
(804) 525-4345
(804) 562-7752
Mailing address
633 NEWTON ST, DANVILLE, VA 24541-2019
(804) 525-4345
(804) 562-7752
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
905-02-014
VA
Other
Enumeration date
06/08/2011
Last updated
01/28/2016
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