Justin's Black Tea and Bread, a Tea Room LLC
NPI #1255684858 in Stafford, Virginia
Provider Information
- NPI Number
- 1255684858
- Entity Type
- Organization
- Organization Name
- Justin's Black Tea and Bread, a Tea Room LLC
- Primary Specialty
- Clinic/Center - Health Service
- Enumeration Date
- Oct 19, 2012
- Last Updated
- Oct 19, 2012
Practice Location
Authorized Official
- Name
- MR. JUSTIN PROCTOR
- Title
- PRESIDENT CEO
- Phone
- (703) 589-5432
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Health Service — Health Service |
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