Organization
WOMEN'S HEALTH CENTER OF SWVA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM TEDRICK JOHN (VP)
(804) 237-7760
Entity
Organization
Contact information
Practice address
101 1ST ST NW, SUITE 1, PULASKI, VA 24301-5603
(540) 980-9170
(540) 980-9175
Mailing address
101 1ST ST NW, SUITE 1, PULASKI, VA 24301-5603
(540) 980-9170
(540) 980-9175
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508030081
—
VA
Enumeration date
04/16/2008
Last updated
07/23/2009
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