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Organization
ROANOKE VALLEY HEALTH SERVICES INC
Active
Organization
ROANOKE VALLEY HEALTH SERVICES INC
Active
Other names
WILDWOOD MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
RUSS GARDNER (CLINICS MANAGER)
(252) 535-1398
Entity
Organization
Contact information
Practice address
2053 RIVER ROAD, HENRICO, NC 27842-0392
(252) 537-9400
(252) 537-1221
Mailing address
PO BOX 392, 2053 RIVER RD, HENRICO, NC 27842-0392
(252) 537-9400
(252) 537-1221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348933A
—
NC
Enumeration date
08/30/2006
Last updated
03/04/2008
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