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1467148544
DERRICK LAMONT CHILDRESS
DANVILLE, VA
NPI
1467148544
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
376J00000X Homemaker
Enumeration Date
2023-04-12
Last Update Date
2023-04-12
Business Address
DERRICK LAMONT CHILDRESS
145 NEW INGRAM RD APT B
DANVILLE, VA 24541-5156
Phone number: 434-713-6375
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Mailing Address
DERRICK LAMONT CHILDRESS
145 NEW INGRAM RD APT B
DANVILLE, VA 24541-5156
Phone number: 434-713-6375
Copy