| NPI | 1215026307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN T EASTON President 276-889-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 5419895171) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2012-10-05 |