NPI | 1215052048 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID LEE STANLEY Franchisee 804-745-9402 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: VA 1101 000684) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2020-08-22 |