| NPI | 1265624654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTHUR L. GLICK Owner 757-499-3163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: VA 0401003730) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2007-08-09 |