Organization
CENTRA HEALTH PROFESSIONAL SERVICES, LLC
Active
Parent organization
CENTRA MEDICAL GROUP, LLC
Other names
Centra Health Medical Center-Danville
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA MEDICAL GROUP, LLC
Authorized official
JOSHUA LARKIN (CREDENTIALING SPECIALIST)
(434) 200-5047
Entity
Organization
Contact information
Practice address
414 PARK AVENUE, DANVILLE, VA 24541-9998
(434) 791-1562
Mailing address
414 PARK AVENUE, DANVILLE, VA 24541-9998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
07/06/2016
Last updated
07/06/2016
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