Organization
ETHAN B. COLLIVER D.O. PLLC
Active
Other names
Colliver Sports and Spine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ETHAN B. COLLIVER D.O. (PRESIDENT)
(540) 345-3556
Entity
Organization
Contact information
Practice address
3706 S MAIN ST, BLACKSBURG, VA 24060-7006
(540) 345-3556
(540) 777-1147
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(540) 345-3556
(540) 777-1147
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0102202537
VA
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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