Organization
CJW SPORTS MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HUNTER LEE DURVIN ATC (PRACTICE MANAGER)
(804) 560-6511
Entity
Organization
Contact information
Practice address
1457 JOHNSTON WILLIS DR, NORTH CHESTERFIELD, VA 23235-4730
(804) 560-6500
(804) 560-6505
Mailing address
1115 BOULDERS PKWY, SUITE 110, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-6511
(804) 560-6505
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
04/13/2013
Last updated
04/13/2013
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