Organization
FCC PETERSBURG
Active
Organization
FCC PETERSBURG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORINNA VAN (BUSINESS ADMINISTRATOR)
(804) 504-7200
Entity
Organization
Contact information
Practice address
1100 RIVER RD, NORTH PRINCE GEORGE, VA 23860-1659
(804) 504-7200
Mailing address
PO BOX 90026, PETERSBURG, VA 23804-9000
(804) 504-7200
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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