Provider Demographics
NPI:1962045138
Name:ALLEN, WILLIAM (PEST CONTROL)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PEST CONTROL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 S PRESTONWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-6625
Mailing Address - Country:US
Mailing Address - Phone:804-461-6110
Mailing Address - Fax:
Practice Address - Street 1:5425 S PRESTONWOOD AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-6625
Practice Address - Country:US
Practice Address - Phone:804-461-6110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA99820-C171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor