| NPI | 1306114780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN VU Practitioner 804-405-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: 0104556895) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |