| NPI | 1053634873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE L MALINCHAK Partner 540-904-7912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: VA 0101-055326) |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2010-07-27 |