Lori Floyd

Individual provider Active NPI Early Intervention Provider Agency · Axton, VA

NPI 1699239574 · NPPES record last updated Jan 25, 2019

Key facts

NPI
1699239574
Entity type
Individual (NPI type 1)
Primary specialty
Early Intervention Provider Agency 252Y00000X
Practice address
16885 Martinsville Hwy
Axton, VA 24054-1929
Phone
(276) 252-3632
NPI assigned
Jan 25, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Yes

Addresses

Primary practice location

16885 Martinsville Hwy
Axton, VA 24054-1929

Mailing address

16885 Martinsville Hwy
Axton, VA 24054-1929
Phone (276) 252-3632

Other identifiers

IdentifierTypeStateIssuer
0167976110MedicaidVA

Other providers in Axton, VA

All providers in Axton, VA · Early Intervention Provider Agency in Virginia

Sources for this page

Verify at the official NPI Registry.