# VIRTUAL URODYNAMICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861782864
- **Authorized official:** DR. CARRIE LYNN CARDA (OWNER)
- **Authorized official phone:** (573) 776-7393

## Contact information

- **Practice address:** 2340 KATY LN, POPLAR BLUFF, MO 63901-2300
- **Practice address phone:** (573) 776-7393
- **Practice address fax:** (573) 776-7396
- **Mailing address:** 2340 KATY LN, POPLAR BLUFF, MO 63901-2300
- **Mailing address phone:** (573) 776-7393
- **Mailing address fax:** (573) 776-7396

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | MD111753 | MO | — |
| 208800000X | Urology Physician | MD111753 | MO | — |
| 261QM2500X | Medical Specialty Clinic/Center | MD111753 | MO | Yes |

## Other

- **Enumeration date:** 04/11/2011
- **Last updated:** 04/11/2011