Provider Demographics
NPI:1740789643
Name:HILL, VIRGINIA LEE
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:LEE
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:LEE
Other - Last Name:HAPPNIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1890 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-3521
Mailing Address - Country:US
Mailing Address - Phone:801-735-4501
Mailing Address - Fax:
Practice Address - Street 1:1890 SOUTH ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-3521
Practice Address - Country:US
Practice Address - Phone:801-735-4501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist