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1871108233
RICKY BROCKINGTON
FRANKLIN, VA
NPI
1871108233
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: VA 0024180104)
Enumeration Date
2020-09-12
Last Update Date
2021-08-12
Business Address
RICKY BROCKINGTON
102 FAIRVIEW DR STE B
FRANKLIN, VA 23851-1206
Phone number: 757-562-2158
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Mailing Address
RICKY BROCKINGTON
19124 LAKESIDE DR
COURTLAND, VA 23837-2634
Phone number: 757-562-2004
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