Organization
LONGWOOD UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNA MCTIGHE PAGE M.ED., ATC (ASST. AD OF SPORTS MEDICINE)
(434) 395-2965
Entity
Organization
Contact information
Practice address
201 HIGH ST, FARMVILLE, VA 23909-1800
(434) 395-2965
Mailing address
201 HIGH ST, FARMVILLE, VA 23909-1800
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
VA
Other
Enumeration date
09/11/2013
Last updated
09/11/2013
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