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General NPI Number Information
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NPI Number | 1316887144
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Entity Type | Organization
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Legal Business Name | MOUNTAIN MEDICAL GROUP, PLLC
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 716 PARK AVE NW
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City | NORTON
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State | VA
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Zip | 24273-1923
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Country | US
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Telephone | 276-219-7178
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1801
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City | WISE
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State | VA
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Zip | 24293-1801
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Country | US
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Telephone | 276-219-7178
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | TAYLOR RAE ROWE
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Credential | FNP
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Telephone | 276-219-7178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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