Organization
CENTER OF INTEGRATIVE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YEDDA STANCIL (OFFICE MANAGER/OWNER)
(804) 353-9355
Entity
Organization
Contact information
Practice address
3536 GROVE AVE, RICHMOND, VA 23221-2200
(804) 353-9355
(804) 359-8344
Mailing address
3536 GROVE AVE, RICHMOND, VA 23221-2200
(804) 353-9355
(804) 353-9383
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
133V00000X
Registered Dietitian
—
—
173C00000X
Reflexologist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/24/2008
Last updated
11/25/2009
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