| NPI | 1275565269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL N ZABA Owner 757-497-9575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 0618000449) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-08-16 |