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Philip J O'Donnell

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NPI Number Detailed Information

Provider Information:

Name: Philip J O'Donnell
Gender: M
Provider License Number If Given: 101028422

NPI Information:

NPI: 1871596924
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 9/8/2020

Provider Business Mailing Address:

Address: 104 SELMA DR
Winchester, VA 22601
Phone Number: 5406782800
Fax Number:

Provider Business Practice Location Address:

Address: 104 SELMA DR
Winchester, VA 22601
Phone Number: 5406782800
Fax Number:

Provider Taxonomy:

Primary: 207RC0000X
Secondary (if any):
State: VA

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