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Octavia King

NPI 1588244925 · on the registry since 2021 · sole proprietor

Practice

Address
7232 Proclamation Dr
Ruther Glen, VA 22546
Phone
(443) 248-1463

Registry record

Primary taxonomy
104100000X
104100000X
Also registered as
171M00000X
Licence states on file
VA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-04-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia