NPI | 1023005139 |
---|---|
Entity Type | Organization |
Authorized Contact | STACI E RUNYON Managed Care Coordinator 540-855-3554 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: VA OH667) |
Enumeration Date | 2005-10-04 |
Last Update Date | 2022-12-30 |