| NPI | 1740572205 |
|---|---|
| Doing Business As | COLLIVER SPORTS AND SPINE CLINIC |
| Entity Type | Organization |
| Authorized Contact | ETHAN B. COLLIVER President 540-345-3556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: VA 0102202537) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |