| NPI | 1053005157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE ARNOLD Director Of Revenue Operations 540-907-2023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-09-11 |