Blue Ridge Medical Management Corporation

NPI #1982998852 in Rural Retreat, Virginia

Provider Information

NPI Number: 1982998852
Entity Type: Organization
Organization Name: Blue Ridge Medical Management Corporation
Primary Specialty: Otolaryngology
Enumeration Date: Jun 8, 2011
Last Updated: Jun 8, 2011

Practice Location

Address: 7021 W LEE HIGHWAY
Address 2: SUITE B
City: Rural Retreat
State: Virginia
ZIP Code: 24368-0000
Phone: (276) 686-3067

Authorized Official

Name: CARL STEVEN KILGORE
Title: PRESIDENT
Phone: (423) 915-5116

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Otolaryngology	207Y00000X	Primary

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