| NPI | 1225358930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN DULANEY Executive Director 540-741-1065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2010-06-03 |