| NPI | 1124337258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNY J. MINOR Pres/Sec/Treas 276-679-2321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: VA 0104000509) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2010-10-07 |