| NPI | 1245449776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY ALAN HAASE Chairman 757-499-9671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101025209) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2011-06-17 |