| Centra Medical Group, Llc | |
|
2010 Atherholt Rd Lynchburg VA 24501-1106 | |
| (434) 200-5047 | |
| Not Available |
| Full Name | Centra Medical Group, Llc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 2010 Atherholt Rd, Lynchburg, Virginia |
| Authorized Official Name and Position | Joshua Larkin (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4342005047 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centra Medical Group, Llc 2010 Atherholt Rd Lynchburg VA 24501-1106 Ph: (434) 200-5047 | Centra Medical Group, Llc 2010 Atherholt Rd Lynchburg VA 24501-1106 Ph: (434) 200-5047 |
| NPI Number | 1649624164 |
|---|---|
| Provider Enumeration Date | 04/21/2016 |
| Last Update Date | 04/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649624164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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