Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2006-10-17
- Last updated
- 2020-08-22
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 104 RUCKER STREET
- City
- STUART VA
- Postal code
- 241710346
- Phone
- 276-694-3163
Organization contact
- Name
- JUDY LACKS
- Title
- Superintendent of Schools
- Phone
- 2766943163
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.