| NPI | 1033153879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RIMON IBRAHIM President 276-926-4601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101051077) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2010-03-31 |