Organization
CAROLINE CHRISTIAN HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRANDI GRAHAM (OFFICE MANAGER)
(804) 448-1380
Entity
Organization
Contact information
Practice address
18048 JEFFERSON DAVIS HWY, RUTHER GLEN, VA 22546-2922
(804) 448-1380
Mailing address
P.O. BOX 216, LADYSMITH, VA 22501-0216
(804) 448-1380
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101231223
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821060047
—
VA
Enumeration date
08/05/2007
Last updated
08/05/2007
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