Organization
CLINCH VALLEY UROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESS JUDY (PRESIDENT)
(615) 565-1508
Entity
Organization
Contact information
Practice address
6719 GOV G. C. PEERY HWY, SUITE 1800, RICHLANDS, VA 24641-2055
(276) 596-6659
(276) 596-6658
Mailing address
6719 GOV G. C. PEERY HWY, SUITE 3650, RICHLANDS, VA 24641-2055
(276) 596-6773
(866) 803-1898
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114955168
—
VA
Enumeration date
06/29/2006
Last updated
04/14/2010
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