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Organization
CTL OF VA LLC
Active
Organization
CTL OF VA LLC
Active
Other names
Joint Regeneration Group of Blacksburg
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT KENNY (AUTHORIZED OFFICIAL)
(904) 576-0786
Entity
Organization
Contact information
Practice address
210 PROFESSIONAL PARK DR SE STE 9, BLACKSBURG, VA 24060-6649
(904) 616-3040
Mailing address
210 PROFESSIONAL PARK DR SE STE 9, BLACKSBURG, VA 24060-6649
(904) 616-3040
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/27/2022
Last updated
03/21/2023
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