| NPI | 1205161122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY MORGAN O PT Ometrist 757-963-6304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: VA 0618001629) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2021-08-16 |