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1538930318
BRANCH LACKES
MECHANICSVILLE, VA
NPI
1538930318
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: VA 0001261881)
Enumeration Date
2024-01-11
Last Update Date
2024-01-11
Business Address
BRANCH LACKES RN
7224 COLD CV
MECHANICSVILLE, VA 23111-3404
Phone number: 804-384-8481
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Mailing Address
BRANCH LACKES RN
7224 COLD CV
MECHANICSVILLE, VA 23111-3404
Phone number: 804-384-8481
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