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Organization

CHILDREN'S MEDICAL CENTER, LTD.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN B. LAFAVE M. D. (PRESIDENT/PHYSICIAN)
(276) 632-9714
Entity
Organization

Contact information

Practice address
15 CLEVELAND AVE, SUITE 14, MARTINSVILLE, VA 24112-2937
(276) 632-9714
(276) 632-0620
Mailing address
15 CLEVELAND AVENUE,, SUITE 14, MARTINSVILLE, VA 24112
(276) 632-9714
(276) 632-0620

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101246331
VA

Other

Enumeration date
10/01/2009
Last updated
10/01/2009
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