| NPI | 1083920706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAZIA HABIB FAROOQI Supervising Physician 804-968-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: VA 0101239733) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2025-10-22 |