Provider Demographics
NPI:1669827721
Name:BISHOP, VICTORIA
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 E HOLT RD
Mailing Address - Street 2:
Mailing Address - City:WEBBERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48892-9205
Mailing Address - Country:US
Mailing Address - Phone:517-505-1148
Mailing Address - Fax:
Practice Address - Street 1:4601 E HOLT RD
Practice Address - Street 2:
Practice Address - City:WEBBERVILLE
Practice Address - State:MI
Practice Address - Zip Code:48892-9205
Practice Address - Country:US
Practice Address - Phone:517-505-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other