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General NPI Number Information
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NPI Number | 1720574569
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Entity Type | Organization
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Legal Business Name | VALLEY GEROPSYCHIATRY LLC
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Dates
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Enumeration Date | 07/05/2018
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 2123B CRYSTAL SPRING AVE SW
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City | ROANOKE
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State | VA
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Zip | 24014-2413
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Country | US
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Telephone | 540-266-3136
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Fax |
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Provider Business Mailing Address
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Address Line | 2123B CRYSTAL SPRING AVE SW
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City | ROANOKE
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State | VA
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Zip | 24014-2413
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID TRINKLE
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Credential | MD
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Telephone | 540-266-1336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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