Provider Demographics
NPI:1861831976
Name:CLINCH VALLEY PHYSICIANS ASSOCIATES LLC
Entity Type:Organization
Organization Name:CLINCH VALLEY PHYSICIANS ASSOCIATES LLC
Other - Org Name:CLINCH VALLEY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7000
Mailing Address - Street 1:1 CLINIC DR
Mailing Address - Street 2:CLAYPOOL HILL
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-1102
Mailing Address - Country:US
Mailing Address - Phone:276-964-6771
Mailing Address - Fax:276-964-1314
Practice Address - Street 1:1 CLINIC DR
Practice Address - Street 2:CLAYPOOL HILL
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-1102
Practice Address - Country:US
Practice Address - Phone:276-964-6771
Practice Address - Fax:276-964-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory