Organization
BLUE RIDGE MEDICAL MANAGEMENT CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARAINE DOVER (DIRECTOR)
(423) 952-2124
Entity
Organization
Contact information
Practice address
1905 AMERICAN WAY, KINGSPORT, TN 37660-5882
(423) 578-8451
(423) 230-8224
Mailing address
509 MED TECH PKWY STE 100, JOHNSON CITY, TN 37604-2579
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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