Organization
BLUE RIDGE MEDICAL MANAGEMENT CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARAINE DOVER (DIRECTOR)
(423) 952-2124
Entity
Organization
Contact information
Practice address
2030 TEMPLE HILL RD, ERWIN, TN 37650-8721
(423) 863-9147
Mailing address
1021 W OAKLAND AVE, JOHNSON CITY, TN 37604-2191
(423) 952-2111
(423) 282-1657
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
08/18/2021
Last updated
10/01/2024
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