Provider Demographics
NPI:1730563073
Name:PUREFOY, DARLA L
Entity type:Individual
Prefix:
First Name:DARLA
Middle Name:L
Last Name:PUREFOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 WEST THOMAS ST
Mailing Address - Street 2:PO BOX 206
Mailing Address - City:BRODNAX
Mailing Address - State:VA
Mailing Address - Zip Code:23920
Mailing Address - Country:US
Mailing Address - Phone:434-327-4727
Mailing Address - Fax:434-729-2015
Practice Address - Street 1:419 WEST THOMAS ST
Practice Address - Street 2:
Practice Address - City:BRODNAX
Practice Address - State:VA
Practice Address - Zip Code:23920
Practice Address - Country:US
Practice Address - Phone:434-327-4727
Practice Address - Fax:434-729-2015
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle