| NPI | 1063256014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QEUNNA DONTE SMITH Owner 757-761-8629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2024-06-24 |