Anna Ellesor Gray Detweiler, CPO

NPI #1356772305 in Norfolk, Virginia

Provider Information

NPI Number: 1356772305
Entity Type: Individual
Name: Anna Ellesor Gray Detweiler, CPO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Prosthetist
Credential: CPO
Enumeration Date: Dec 2, 2013
Last Updated: Jan 10, 2014

Practice Location

Address: 6320 N CENTER DR
Address 2: BLDG 15 SUITE 201
City: Norfolk
State: Virginia
ZIP Code: 23502-4009
Phone: (757) 892-5300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthotist	222Z00000X
Prosthetist	224P00000X	Primary

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