| NPI | 1215482252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BRICKER Executive Director 540-433-4913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: VA 0024173713) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2016-08-19 |