Like many Virginia county seats, Heathsville is a small community, having grown little over the past century. There has been minimal suburban development over the past fifty years; the town is still compact. Growth has concentrated along Routes 360 and 201, gradually spreading out from the old village core. Rt. 360, which serves as the main street of the village, extends (via Routes 202 and 3) to either end of the great peninsula known as the Northern Neck; it connects Heathsville with Reedville to the east, and with Callao, Warsaw, Montross, and Fredericksburg to the west. Rt. 360 intersects with Rt. 201 near the south end of town; the latter road connects Heathsville with Lancaster Court House and Kilmarnock in the southeast section of the peninsula.
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