| NPI | 1053322495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CLAUDE COLE Owner 276-694-4466 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101 036915) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101 237621) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2026-02-10 |