| NPI | 1730405069 |
|---|---|
| Doing Business As | DBA: INTEGRATIVE SPORTS MEDICINE OF BLUE RIDGE |
| Entity Type | Organization |
| Authorized Contact | STEFANIE L SHAVER Owner 706-632-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: GA 056647) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 056647) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2010-04-14 |