Organization
PHYSIATRY-SPORTS & FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS LEE (PRESIDENT)
(757) 366-0200
Entity
Organization
Contact information
Practice address
2147 OLD GREENBRIER RD, SUITE B, CHESAPEAKE, VA 23320-2635
(757) 366-0200
Mailing address
PO BOX 15763, CHESAPEAKE, VA 23328-5763
(757) 366-0200
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
0101241301
VA
Other
Enumeration date
11/19/2014
Last updated
10/16/2015
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