Providence Family & Sports Medicine, Inc

NPI 1053403378 - Family Medicine - 207Q00000X

NPI Details
NPI 1053403378
Enumeration Date 09/28/2006
Last Updated 08/06/2010
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name LISA CAMPBELL LISA
Position OFFICE MANAGER
Phone (434) 791-4110
Fax (434) 791-4003
Practice Location
441 PINEY FOREST RD
SUITE E
DANVILLE VA, 24540-4154, US
Phone (434) 791-4110
Fax (434) 791-4003
Business Location
441 PINEY FOREST RD
SUITE E
DANVILLE VA, 24540-4154, US
Phone (434) 791-4110
Fax (434) 791-4003
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
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According to our database, Providence Family & Sports Medicine, Inc NPI is 1053403378, taxonomy code is 207Q00000X Providence Family & Sports Medicine, Inc physically located at 441 Piney Forest Rd, Danville VA, 24540-4154. NPI Number 1033115704 has the healthcare provider type.

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1053403378 NPI number is provided on an as is basis without warranty of any kind. 1053403378 is maintained by the National Plan & Provider Enumeration System. The contents of Providence Family & Sports Medicine, Inc are for informational purposes only.