Organization
CITY OF ROANOKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA GAY VIA FNP (MANAGER)
(540) 853-2045
Entity
Organization
Contact information
Practice address
120 KIRK AVE SW, ROANOKE, VA 24011-1602
(540) 853-2045
(540) 853-2911
Mailing address
120 KIRK AVE SW, ROANOKE, VA 24011-1602
(540) 853-2045
(540) 853-2911
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0024069675
VA
Other
Enumeration date
09/27/2006
Last updated
06/18/2008
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