NPI | 1053754028 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT P. HOSTLER Director/CEO/President 703-359-7200 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL HCC9758) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: FL 23433) |
Enumeration Date | 2013-04-09 |
Last Update Date | 2020-10-21 |