| NPI | 1104198001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADYA CARRIGER Owner 703-596-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0024169591) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2018-06-16 |