Organization
ELJV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH ANN WATSON (ADMINISTRATOR)
(757) 938-3654
Entity
Organization
Contact information
Practice address
1729 WILDWOOD DR STE 103A, VIRGINIA BEACH, VA 23454-3176
(757) 938-3654
(757) 938-3658
Mailing address
1729 WILDWOOD DR STE 103A, VIRGINIA BEACH, VA 23454-3176
(757) 938-3654
(757) 938-3658
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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