| NPI | 1295893097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCHELL B MILLER President 757-563-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101032190) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2009-01-30 |