Healthcare Provider Details

I. General information

NPI: 1235490608
Provider Name (Legal Business Name): LINDSAY POMRENKE CALL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 S MAIN ST
BLACKSBURG VA
24060-7017
US

IV. Provider business mailing address

3700 SOUTH MAIN STREET SUITE 1A
BLACKSBURG VA
24060
US

V. Phone/Fax

Practice location:
  • Phone: 540-443-7180
  • Fax:
Mailing address:
  • Phone: 540-444-7180
  • Fax: 540-443-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number2990
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number0102204160
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102204160
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: