NPI | 1174712301 |
---|---|
Entity Type | Organization |
Authorized Contact | CONNIE D LE President 703-642-6633 |
Organization Subpart ? | |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 0101237697) |
Enumeration Date | 2007-10-24 |
Last Update Date | 2007-10-24 |