Organization
CJW SPORTS MEDICINE LLC
Active
Other names
no dba CJW Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL SMITH (VP)
(804) 237-7760
Entity
Organization
Contact information
Practice address
5309 COMMONWEALTH PARKWAY, SUITE 100, RICHMOND, VA 23112
(804) 745-9000
(804) 330-7055
Mailing address
5309 COMMONWEALTH PARKWAY, SUITE 100, RICHMOND, VA 23112
(804) 745-9000
(804) 330-7055
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770572885
—
VA
Enumeration date
10/20/2005
Last updated
09/26/2007
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