Organization
ETHAN B. COLLIVER D.O. PLLC
Active
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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