| NPI | 1043339989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MCNUTT Billing Manager 276-935-4858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101049088) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2009-11-20 |