| NPI | 1275644908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTIS W BLACKWOOD Practice Administrator 540-772-3672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101236052) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |