DONNIE LEE BROADWATER

BIG STONE GAP, VA
NPI1841314069
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy247200000X 
Enumeration Date2007-03-16
Last Update Date2007-07-08
Business Address
Mr. DONNIE LEE BROADWATER
622 POWELL AVE DEVELOPMENTAL SERVICE
BIG STONE GAP, VA 24219
Phone number: 276-523-0682
Mailing Address
Mr. DONNIE LEE BROADWATER
PO BOX 9054
GRAY, TN 37615-9054
Phone number: 423-467-3600
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