Organization
CENTRA MEDICAL GROUP, LLC
Active
Parent organization
CENTRA MEDICAL GROUP, LLC
Other names
Autism Diagnostic Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA MEDICAL GROUP, LLC
Authorized official
LEWIS ADDISON (SR VP CFO)
(434) 200-5047
Entity
Organization
Contact information
Practice address
693 LEESVILLE RD, LYNCHBURG, VA 24502-2828
(434) 200-5700
Mailing address
2010 ATHERHOLT RD, LYNCHBURG, VA 24501-1106
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
06/11/2006
Last updated
01/15/2014
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