Provider Demographics
NPI:1407192735
Name:VIRGINIA INTERVENTIONAL PAIN & SPINE CENTER, INC.
Entity Type:Organization
Organization Name:VIRGINIA INTERVENTIONAL PAIN & SPINE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHHEANY
Authorized Official - Middle Name:
Authorized Official - Last Name:UNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-777-0090
Mailing Address - Street 1:PO BOX 8310
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-0310
Mailing Address - Country:US
Mailing Address - Phone:540-777-0090
Mailing Address - Fax:
Practice Address - Street 1:3800 ELECTRIC RD STE 307
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4568
Practice Address - Country:US
Practice Address - Phone:540-777-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-13
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty