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Organization
BRAIN INJURY SERVICES OF SWVA
Active
Organization
BRAIN INJURY SERVICES OF SWVA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODI JUDGE (EXECUTIVE DIRECTOR)
(540) 344-1200
Entity
Organization
Contact information
Practice address
3904 FRANKLIN RD SW STE B, ROANOKE, VA 24014-3039
(540) 344-1200
Mailing address
3904 FRANKLIN RD SW STE B, ROANOKE, VA 24014-3039
(540) 344-1200
Taxonomy
Speciality
Code
Description
License number
State
2084P0301X
Brain Injury Medicine (Psychiatry & Neurology) Physician
Primary
—
NULL
2084P0301X
Brain Injury Medicine (Psychiatry & Neurology) Physician
Primary
—
—
251B00000X
Case Management Agency
—
NULL
Other
Enumeration date
05/01/2023
Last updated
11/06/2023
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