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 |