| NPI | 1215936547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANNE LAND SIEGRIST Vice President CEO 804-748-6229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0102037170) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102037160) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2008-04-20 |