Provider Demographics
NPI:1265627103
Name:DOMINION CRAFTSMAN SERVICES,LLC
Entity type:Organization
Organization Name:DOMINION CRAFTSMAN SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ULLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-508-5976
Mailing Address - Street 1:5011 WARWICK HILLS CT
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-3185
Mailing Address - Country:US
Mailing Address - Phone:703-508-5976
Mailing Address - Fax:571-261-2746
Practice Address - Street 1:5011 WARWICK HILLS CT
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-3185
Practice Address - Country:US
Practice Address - Phone:703-508-5976
Practice Address - Fax:571-261-2746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705105044171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty