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Organization
WOMEN'S HEALTH CENTER OF SWVA LLC
Active
Organization
WOMEN'S HEALTH CENTER OF SWVA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM TEDRICK JOHN (VP)
(804) 237-7760
Entity
Organization
Contact information
Practice address
101 1ST ST NW, SUITE 1, PULASKI, VA 24301-5603
(540) 980-9170
(540) 980-9175
Mailing address
101 1ST ST NW, SUITE 1, PULASKI, VA 24301-5603
(540) 980-9170
(540) 980-9175
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508030081
—
VA
Enumeration date
04/16/2008
Last updated
07/23/2009
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