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 |