| NPI | 1043463466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON M. FINCH Owner 276-466-0744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101223610) |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2012-12-12 |