| NPI | 1255413027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTIS BLACKWOOD Practice Administrator 540-772-5992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: VA 0101026794) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |