| NPI | 1316324486 |
|---|---|
| Other Name | FOURTH STREET VA CLINIC |
| Entity Type | Organization |
| Authorized Contact | ERIN POTTER Npi Team Member 202-382-2579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2023-01-05 |