Organization
MONTGOMERY REGIONAL HOSPITAL--CRNA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA A WICKLINE (PATIENT ACCESS SUPVR)
(540) 953-5123
Entity
Organization
Contact information
Practice address
3700 S MAIN ST, BLACKSBURG, VA 24060-7017
(540) 953-5123
(540) 961-4673
Mailing address
3700 S MAIN ST, BLACKSBURG, VA 24060-7017
(540) 953-5123
(540) 961-4673
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0024097342
VA
Other
Enumeration date
11/06/2006
Last updated
08/22/2020
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