| NPI | 1104398205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHE MONTE TORRY Owner/Physician 757-310-6413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2018-12-30 |
| Last Update Date | 2024-08-27 |