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Organization

CENTRA HEALTH PROFESSIONAL SERVICES, LLC

Active
Parent organization
CENTRA HEALTH PROFESSIONAL SERVICES, LLC
Other names
Centra Thoracic Surgery
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRA HEALTH PROFESSIONAL SERVICES, LLC
Authorized official
LEWIS ADDISON (CFO)
(434) 200-3656
Entity
Organization

Contact information

Practice address
1701 THOMSON DR, LYNCHBURG, VA 24501-1118
(434) 200-6262
Mailing address
1204 FENWICK DR, LYNCHBURG, VA 24502-2112

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary

Other

Enumeration date
06/12/2012
Last updated
06/12/2012
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