| NPI | 1295562783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA LOGAN CEO 540-977-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2025-01-03 |