Healthcare Provider Details

I. General information

NPI: 1881886463
Provider Name (Legal Business Name): WOMEN'S HEALTH SPECTRUM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 HOSPITAL DR SUITE 204
MARTINSVILLE VA
24112-1929
US

IV. Provider business mailing address

319 HOSPITAL DR SUITE 204
MARTINSVILLE VA
24112-1929
US

V. Phone/Fax

Practice location:
  • Phone: 276-632-2999
  • Fax: 276-632-1551
Mailing address:
  • Phone: 276-632-2999
  • Fax: 276-632-1551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0102202073
License Number StateVA

VIII. Authorized Official

Name: DR. TERRI EUGENIA YOUNGER-EURE
Title or Position: CEO
Credential: D.O.
Phone: 276-632-2999