Provider First Line Business Practice Location Address:
2001 CRYSTAL SPRING AVE, CARILION MEDICAL CENTER PHCY
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
ROANOKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-853-0905
Provider Business Practice Location Address Fax Number:
540-853-0910
Provider Enumeration Date:
06/25/2007