| NPI | 1174793400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA SHEA KENNEDY President 757-547-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101039112) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-03-10 |