Provider Demographics
NPI:1558147512
Name:STOREY, FRANK
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:STOREY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE FORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23140-0460
Mailing Address - Country:US
Mailing Address - Phone:757-903-9289
Mailing Address - Fax:
Practice Address - Street 1:3530 N COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:PROVIDENCE FORGE
Practice Address - State:VA
Practice Address - Zip Code:23140-3408
Practice Address - Country:US
Practice Address - Phone:804-409-7525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program