Most Relevant Information
Provider Data
| NPI Number: | 1003216938 |
| Provider Name: | DESIREE STANNARD |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 2306603919 |
Most Important Dates
| Enumeration Date: | 08/28/2014 |
| Last Updated: | 08/28/2014 |
Provider Practice Location
7090 COVENANT WOODS DR
MECHANICSVILLE
VA
23111
Practice Location Phone/Fax
| Phone: | 8045698000 |
| Fax: |
Provider Mailing Location
7090 COVENANT WOODS DR
MECHANICSVILLE
VA
23111
Provider Mailing Phone/Fax
| Phone: | 8045698000 |
| Fax: |