| NPI | 1174226146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRYSTAL GAMMON Owner/Operator 434-429-2383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QI0500X Clinic/Center, Infusion Therapy |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-04-18 |