NPI Provider: 1528063013
Contact Name: Bonner Henderson Charles
Position: Medical Director
Phone: (804) 282-6953
Southern Physical Medicine Associates, Inc Information:
Southern Physical Medicine Associates, Inc organization have npi 1528063013, taxonomy code is 2080S0010X with license number is 715002791 in . This Business address located in 5922 W Broad St, Richmond, VA 23230 Virginia.
Practice Location
Address: 5922 W Broad St, Richmond, VA 23230
Phone: (804) 282-6953
Business Location
Address: 5922 W Broad St, Richmond, VA 23230
Phone: (804) 282-6953
Fax: (804) 282-8215
Taxonomy
Taxonomy Code: 2080S0010X
License Number: 715002791
License Number of State: VA
Primary Taxonomy Switch: X
Enumeration Date: 6/20/2005
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