| NPI | 1124200258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC CURRY V.P. Operations 757-410-4008 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101047699) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2024-08-15 |