Individual
SHAINE POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
323 CLOVERLEAF SQ # 1, BIG STONE GAP, VA 24219-2760
(276) 523-6715
(276) 523-6719
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102208658
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2020
Last updated
10/25/2024
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