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General NPI Number Information
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NPI Number | 1306940028
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE PAIN TREATMENT CENTERS
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 10/22/2011
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Provider Practice Location Address
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Address Line | 2034 PRO POINTE LN
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City | HARRISONBURG
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State | VA
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Zip | 22801-8021
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Country | US
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Telephone | 540-433-3300
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Fax | 540-433-7063
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Provider Business Mailing Address
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Address Line | 2034 PRO POINTE LN
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City | HARRISONBURG
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State | VA
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Zip | 22801-8021
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Country | US
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Telephone | 540-433-3300
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Fax | 540-433-7063
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | JOHN E SHERRY II
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Credential | M.D.
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Telephone | 540-560-2719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 0101059231
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License Number State | VA
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