| NPI | 1285337154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY LEE MORO Administrator 757-962-7583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 208100000X Physical Medicine & Rehabilitation | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2025-06-13 |