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Organization

PETERSBURG CLINIC COMPANY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBBIE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization

Contact information

Practice address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5991
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
207RG0100X
Gastroenterology Physician
208600000X
Surgery Physician
208VP0000X
Pain Medicine Physician
261Q00000X
Clinic/Center
363L00000X
Nurse Practitioner

Other

Enumeration date
05/09/2006
Last updated
06/30/2011
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