# CENTRA MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Centra Weight Loss Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215689583
- **Authorized official:** SONYA R T DAVIS (SENIOR DIRECTOR REVENUE CYCLE)
- **Authorized official phone:** (434) 200-6942

## Contact information

- **Practice address:** 125 NATIONWIDE DR, LYNCHBURG, VA 24502-4272
- **Practice address phone:** (434) 200-2500
- **Mailing address:** 1937 THOMSON DR, LYNCHBURG, VA 24501-1008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/19/2022
- **Last updated:** 01/19/2022