Organization
CENTRA MEDICAL GROUP, LLC
Active
Parent organization
CENTRA MEDICAL GROUP, LLC
Other names
Centra Medical Group Urologh
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRA MEDICAL GROUP, LLC
Authorized official
LEWIS ADDISON (SR VP CFO)
(434) 200-5047
Entity
Organization
Contact information
Practice address
1330 OAK LN, SUITE 203, LYNCHBURG, VA 24503-2513
(434) 200-6620
Mailing address
2010 ATHERHOLT RD, LYNCHBURG, VA 24501-1106
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
05/27/2008
Last updated
04/10/2014
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