Provider Demographics
NPI:1922255637
Name:ROCKBRIDGE TRADITIONAL MEDICINE
Entity Type:Organization
Organization Name:ROCKBRIDGE TRADITIONAL MEDICINE
Other - Org Name:DR CATHRYN K HARBOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHRYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARBOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-463-2882
Mailing Address - Street 1:104 S JEFFERSON ST
Mailing Address - Street 2:PO BOX 1506
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450
Mailing Address - Country:US
Mailing Address - Phone:540-463-2882
Mailing Address - Fax:540-463-2829
Practice Address - Street 1:104 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2027
Practice Address - Country:US
Practice Address - Phone:540-463-2882
Practice Address - Fax:540-463-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101050011261QV0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAOOW891R01Medicare PIN