Organization
COMMONWEALTH SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERESA S STADLER M.D. (OWNER)
(804) 270-7750
Entity
Organization
Contact information
Practice address
4300 POUNCEY TRACT RD, SUITE F, GLEN ALLEN, VA 23060-6007
(804) 270-7750
(804) 497-8625
Mailing address
4300 POUNCEY TRACT RD, SUITE F, GLEN ALLEN, VA 23060-6007
(804) 270-7750
(804) 497-8625
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101238212
VA
Other
Enumeration date
12/27/2006
Last updated
04/08/2014
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