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General NPI Number Information
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NPI Number | 1467631416
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Entity Type | Organization
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Legal Business Name | ROCKBRIDGE MIDWIFERY CARE, LLC
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 170 W 29TH ST
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City | BUENA VISTA
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State | VA
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Zip | 24416-1312
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Country | US
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Telephone | 540-261-1410
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Fax | 540-261-1409
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Provider Business Mailing Address
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Address Line | 170 W 29TH ST
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City | BUENA VISTA
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State | VA
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Zip | 24416-1312
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Country | US
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Telephone | 540-261-1410
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Fax | 540-261-1409
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Authorized Official
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Title or Position | CO-DIRECTOR
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Name | JULIE MARTIN
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Credential | CPM, LM
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Telephone | 540-261-1410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 0129000008
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License Number State | VA
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