Organization
TAMARACK CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD WOODROW BRILL JR. PH.D. (OWNER/OPERATOR)
(276) 591-1133
Entity
Organization
Contact information
Practice address
800 EUCLID AVE, BRISTOL, VA 24201-3916
(276) 591-1122
(276) 591-1150
Mailing address
800 EUCLID AVE, BRISTOL, VA 24201-3916
(276) 591-1122
(276) 591-1150
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
08100002356
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007727
VALUE OPTIONS
VA
01
—
056271
TRIGON
VA
01
—
4037985
BCBS TN
VA
Enumeration date
08/12/2005
Last updated
04/20/2008
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