Susie Faltz

Individual provider Active NPI Private Vehicle · Smithfield, VA

NPI 1831684182 · NPPES record last updated Jun 28, 2018

Key facts

NPI
1831684182
Entity type
Individual (NPI type 1)
Primary specialty
Private Vehicle 347C00000X
License
T65520517 (VA)
Practice address
208 Deer Spring LN
Smithfield, VA 23430-2942
Phone
(757) 357-0809
Fax
(757) 357-0809
NPI assigned
Jun 28, 2018
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

State licenses

LicenseStateTypeSpecialty
T65520517VAMDPrivate Vehicle

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X T65520517 VA Yes

Addresses

Primary practice location

208 Deer Spring LN
Smithfield, VA 23430-2942

Mailing address

208 Deer Spring LN
Smithfield, VA 23430-2942
Phone (757) 357-0809

Other providers in Smithfield, VA

All providers in Smithfield, VA · Private Vehicle in Virginia

Sources for this page

Verify at the official NPI Registry.