| Organization Name: | COMMONWEALTH ALLERGY LLC |
| NPI Number: | 1053714816 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY C GEORGE (OWNER) |
| Mailing Address: | 201 Concourse Blvd Ste 100 Glen Allen |
| State: | VA US |
| Postal Code: | 230595640 |
| Phone Number: | 8049684824 |
| Fax Number: | 8049684824 |
| NPI Enumeration Date: | 10/07/2014 |
| NPI Last Update Date: | 10/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207KA0200X |
| License Number: | 0101239959 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Allergy & Immunology |
| Taxonomy Specialization: | Allergy |
| Taxonomy Definition: | |