Crater Child Development Clinic
NPI #1164468823 in Petersburg, Virginia
Provider Information
- NPI Number
- 1164468823
- Entity Type
- Organization
- Organization Name
- Crater Child Development Clinic
- Primary Specialty
- Public Health or Welfare
- Enumeration Date
- Jun 21, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2002 WAKEFIELD STREET
- City
- Petersburg
- State
- Virginia
- ZIP Code
- 23805-2112
- Phone
- (804) 862-6186
Authorized Official
- Name
- DR. MICHAEL OWEN ROYSTER, MD
- Title
- DISTRICT HEALTH DIRECTOR
- Phone
- (804) 863-1663
Specialties & Taxonomy Codes
| Specialty |
|---|
| Public Health or Welfare |
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