Organization
MOUNTAIN EMPIRE OLDER CITZENS PACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONY LAWSON (DIRECTOR)
(276) 523-0599
Entity
Organization
Contact information
Practice address
1508 3RD AVE EAST, BIG STONE GAP, VA 24219-0888
(276) 523-0599
(276) 523-4690
Mailing address
PO BOX 888, BIG STONE GAP, VA 24219-0888
(276) 523-0599
(276) 523-4690
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
—
—
Other
Enumeration date
12/17/2012
Last updated
06/03/2022
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