Provider First Line Business Practice Location Address:
112 CROFTON PLACE
Provider Second Line Business Practice Location Address:
UVA LAKE MONTICELLO INTERNAL MEDICINE
Provider Business Practice Location Address City Name:
PALMYRA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22963
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-589-9030
Provider Business Practice Location Address Fax Number:
434-589-9040
Provider Enumeration Date:
07/20/2006