| NPI | 1073818787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILY WISE HARGROVE Owner 434-466-8363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101057199) |
| Enumeration Date | 2011-01-12 |
| Last Update Date | 2011-04-18 |