# SHENANDOAH PREVENTIVE MEDICINE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** J.A. Burgess V, D.O.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518089366
- **Authorized official:** DR. JOHN ALEXANDER BURGESS V D.O. (PRESIDENT)
- **Authorized official phone:** (304) 263-3335

## Contact information

- **Practice address:** 215 S LOUISIANA AVE, MARTINSBURG, WV 25401-2037
- **Practice address phone:** (304) 263-3335
- **Practice address fax:** (304) 267-5557
- **Mailing address:** 215 S LOUISIANA AVE, MARTINSBURG, WV 25401-2037
- **Mailing address phone:** (304) 263-3335
- **Mailing address fax:** (304) 267-5557

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 1000 | WV | Yes |

## Other

- **Enumeration date:** 04/04/2007
- **Last updated:** 08/22/2020