Provider Demographics
NPI:1073674966
Name:VIRGINIA HIGHLANDS ORTHOPAEDIC SPINE CENTER, LLC
Entity Type:Organization
Organization Name:VIRGINIA HIGHLANDS ORTHOPAEDIC SPINE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART-WIEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-633-0523
Mailing Address - Street 1:304 DAVIS STREET
Mailing Address - Street 2:P.O. BOX 797
Mailing Address - City:INDEPENDENCE
Mailing Address - State:VA
Mailing Address - Zip Code:24348
Mailing Address - Country:US
Mailing Address - Phone:276-773-8145
Mailing Address - Fax:276-773-3912
Practice Address - Street 1:304 DAVIS STREET
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:VA
Practice Address - Zip Code:24348
Practice Address - Country:US
Practice Address - Phone:276-773-8145
Practice Address - Fax:276-773-3912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy