Chippenham & Johnston Willis Sports Medicine, LLC

NPI #1467576249 in Midlothian, Virginia

Provider Information

NPI Number: 1467576249
Entity Type: Organization
Organization Name: Chippenham & Johnston Willis Sports Medicine, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: CJW MEDICAL CENTER
Primary Specialty: Specialist
Enumeration Date: Mar 19, 2007
Last Updated: Jan 29, 2008

Practice Location

Address: 5309 COMMONWEALTH CENTRE PARKWAY
Address 2: SUITE 100
City: Midlothian
State: Virginia
ZIP Code: 23112
Phone: (804) 560-6500

Authorized Official

Name: MR. HUNTER LEE DURVIN, ATC
Title: MANAGER
Phone: (804) 560-6511

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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