| NPI | 1003987819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE SUMMERLIN Practice Administrator 757-893-1700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2008-01-18 |