| NPI | 1043883143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE BRANDON MILLER Fnp/Apmhcns 571-314-6136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-07-19 |