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General NPI Number Information
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NPI Number | 1326235581
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Entity Type | Organization
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Legal Business Name | 4 GENERATIONS FAMILY MEDICAL AND WELLNESS CENTER, P.C.
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 07/13/2009
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Provider Practice Location Address
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Address Line | 1 E MARKET ST SUITE #C
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City | MARTINSVILLE
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State | VA
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Zip | 24112-3708
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Country | US
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Telephone | 276-656-2185
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Fax | 276-656-2186
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Provider Business Mailing Address
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Address Line | 1 E MARKET ST SUITE #C
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City | MARTINSVILLE
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State | VA
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Zip | 24112-3708
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Country | US
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Telephone | 276-656-2185
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Fax | 276-656-2186
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Authorized Official
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Title or Position | CEO/PHYSICIAN
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Name | DR. HOWIS YVETTE TOLER
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Credential | M.D.
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Telephone | 276-656-2185
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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 | 0101241172
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License Number State | VA
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