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445 Gienow Rd Rural Retreat VA 24368-3210 | |
(276) 686-4007 | |
(276) 686-4581 |
Full Name | |
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Speciality | Family Medicine |
Location | 445 Gienow Rd, Rural Retreat, Virginia |
Authorized Official Name and Position | Kimberly K Lacy (PHYSICIAN) |
Authorized Official Contact | 2766864007 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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445 Gienow Rd Rural Retreat VA 24368-3210 Ph: (276) 686-4007 | 445 Gienow Rd Rural Retreat VA 24368-3210 Ph: (276) 686-4007 |
NPI Number | 1588910756 |
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Provider Enumeration Date | 07/25/2012 |
Last Update Date | 07/25/2012 |
Identifier | Type | State | Issuer |
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1588910756 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Blue Ridge Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 445 Gienow Rd, Rural Retreat, VA 24368 Phone: 276-686-4007 |