Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
Child Development Clinic Southside
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY GATELEY M.D. (DIRECTOR)
(434) 766-9800
Entity
Organization
Contact information
Practice address
326 TAYLOR DR, DANVILLE, VA 24541-4023
(434) 766-9800
(434) 799-5022
Mailing address
326 TAYLOR DR, DANVILLE, VA 24541-4023
(434) 766-9800
(434) 799-5022
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0049-76-100
—
VA
01
—
27559
SENTATA/OPTIMA
VA
Enumeration date
11/09/2006
Last updated
03/31/2016
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