Organization
JEFFERSON SURGICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON C BOWEN CCS-P (BILLING MANAGER)
(540) 283-6071
Entity
Organization
Contact information
Practice address
1234 FRANKLIN RD SW, ROANOKE, VA 24016-4606
(540) 283-6071
(540) 283-6098
Mailing address
1234 FRANKLIN RD SW, ROANOKE, VA 24016-4606
(540) 283-6071
(540) 283-6098
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
VA
Other
Enumeration date
06/25/2006
Last updated
07/18/2013
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