| NPI | 1205278272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | E.W. TIBBS, JR. CEO 434-200-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171009) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2013-07-19 |