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20209 Sentara Way Carrollton VA 23314-3573 | |
(757) 772-6125 | |
(757) 267-9196 |
Full Name | |
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Speciality | Clinic/center |
Location | 20209 Sentara Way, Carrollton, Virginia |
Authorized Official Name and Position | Alan Ayers (PRESIDENT) |
Authorized Official Contact | 7798880734 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4374 New Town Ave Williamsburg VA 23188-2865 Ph: (757) 772-6124 | 20209 Sentara Way Carrollton VA 23314-3573 Ph: (757) 772-6125 |
NPI Number | 1235645912 |
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Provider Enumeration Date | 12/18/2017 |
Last Update Date | 12/18/2017 |
Identifier | Type | State | Issuer |
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1235645912 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |