| Main Clinic | |
|
1802 Braeburn Dr Salem VA 24153-7357 | |
| (540) 772-3671 | |
| (540) 725-5067 |
| Full Name | Main Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1802 Braeburn Dr, Salem, Virginia |
| Authorized Official Name and Position | Sherry Robertson (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 5407723671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Clinic 1802 Braeburn Dr Salem VA 24153-7357 Ph: (540) 772-3671 | Main Clinic 1802 Braeburn Dr Salem VA 24153-7357 Ph: (540) 772-3671 |
| NPI Number | 1205810264 |
|---|---|
| Provider Enumeration Date | 12/02/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205810264 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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