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Organization

INDEPENDENCE FAMILY CARE CENTER, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NANCE ANN LOVELACE DO (PRESIDENT)
(276) 773-2111
Entity
Organization

Contact information

Practice address
217 S INDEPENDENCE AVE, INDEPENDENCE, VA 24348-2802
(276) 773-2111
(273) 773-2942
Mailing address
217 S INDEPENDENCE AVE, INDEPENDENCE, VA 24348-2802
(276) 773-2111
(273) 773-2942

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010084326
VA
05
010094640
VA
05
010134129
VA
01
143862
BCBS
VA
01
S66686
REYNOLDS
VA
Enumeration date
06/11/2006
Last updated
03/16/2011
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