Individual
ELIZA WIDENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 LAMB CIR, SUITE L760, CHRISTIANSBURG, VA 24073-6344
(540) 731-2581
Mailing address
4210 CUMBERLAND DR, CHRISTIANSBURG, VA 24073-4652
(276) 356-8738
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001879
VA
Other
Enumeration date
10/11/2013
Last updated
10/11/2013
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