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Diera Parhamcarruthers

NPI Registration Record

Provider / OrganizationNPIDate Certified
DIERA PARHAMCARRUTHERS14478772042020-06-28
Entity TypeIndividual
Provider Name Diera Parhamcarruthers
Practice Office Address4532 PLANK RD
FREDERICKSBURG, VA US
Practice Office Telephone5402707480
Mailing Address6106 PATRICIAN CT
FREDERICKSBURG, VA 224078405 US
Business Telephone5404677497
HPT Codes
CodeLicense NoState
101YP2500X0704007656 VA
101YM0800X PRIMARYPRC15344 DC
OPI Codes

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