Organization
TOTAL SKIN CARE AND LASER CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP E GRUBBS MD (MEDICAL DIRECTOR)
(540) 951-3429
Entity
Organization
Contact information
Practice address
817 DAVIS ST, SUITE 2, BLACKSBURG, VA 24060-7013
(540) 951-3429
(540) 951-8887
Mailing address
817 DAVIS ST, SUITE 2, BLACKSBURG, VA 24060-7013
(540) 951-3429
(540) 951-8887
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101051261
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
175050
ANTHEM
VA
Enumeration date
01/23/2007
Last updated
08/22/2020
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