Colliver Sports & Spine INC

NPI #1447545751 in Blacksburg, Virginia

Provider Information

NPI Number: 1447545751
Entity Type: Organization
Organization Name: Colliver Sports & Spine INC
Primary Specialty: Physical Medicine & Rehabilitation
Enumeration Date: Jun 15, 2011
Last Updated: Dec 16, 2022

Practice Location

Address: 120 PROFESSIONAL PARK DR SE STE 7
City: Blacksburg
State: Virginia
ZIP Code: 24060-6739
Phone: (540) 443-3832

Authorized Official

Name: DR. ETHAN B COLLIVER, DO
Title: PRESIDENT
Phone: (540) 553-4587

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Internal Medicine - Sports Medicine — Sports Medicine	207RS0010X
Pediatrics	208000000X
Physical Medicine & Rehabilitation	208100000X	Primary

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