Larry Dean Nycum SR.

NPI #1952893315 in Millboro, Virginia

Provider Information

NPI Number: 1952893315
Entity Type: Individual
Name: Larry Dean Nycum SR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Private Vehicle
Enumeration Date: Jun 1, 2018
Last Updated: Jun 1, 2018

Practice Location

Address: 5918 COWPASTURE RIVER HWY
City: Millboro
State: Virginia
ZIP Code: 24460-2490
Phone: (540) 460-0869

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Private Vehicle	347C00000X	Primary

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