| Cjw Sports Medicine, Llc | |
|
1115 Boulders Pkwy Suite 110 North Chesterfield VA 23225-4067 | |
| (804) 560-6500 | |
| (804) 560-6505 |
| Full Name | Cjw Sports Medicine, Llc |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 1115 Boulders Pkwy, North Chesterfield, Virginia |
| Authorized Official Name and Position | Hunter L. Durvin (PRACTICE MANAGER) |
| Authorized Official Contact | 8045606511 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cjw Sports Medicine, Llc 1115 Boulders Pkwy Suite 110 North Chesterfield VA 23225-4067 Ph: (804) 560-6500 | Cjw Sports Medicine, Llc 1115 Boulders Pkwy Suite 110 North Chesterfield VA 23225-4067 Ph: (804) 560-6500 |
| NPI Number | 1639448962 |
|---|---|
| Provider Enumeration Date | 12/15/2011 |
| Last Update Date | 12/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639448962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
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Cjw Sports Medicine, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1457 Johnston Willis Dr, North Chesterfield, VA 23235 Phone: 804-560-6500 Fax: 804-560-6505 | |
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