| NPI | 1255515474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW C. LEE Sole Proprietor 804-241-4293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101239897) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2009-08-24 |