| NPI | 1215110952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE KAVANAGH Billing Director 757-481-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101045785) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2017-07-05 |