NPI 1003465402
Moniesha Avita Javon Bullock
Practice location
- Address
- 508 Little Margaret Ln, Henrico, VA 23075-1647
- Phone
- (804) 822-8661
Registered specialties
In Home Supportive Care Agency
Primary
Registry record
- NPI
- 1003465402
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 9 Sep 2019
- Record last updated
- 9 Sep 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.