| NPI | 1013187947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSUE APILAN MIRANDA Owner 757-473-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101034998) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-07 |