| NPI | 1326211616 |
|---|---|
| Other Name | JESSE JAMES-DIR |
| Entity Type | Organization |
| Authorized Contact | JESSE JAMES CALLOWAY Director/Owner 434-229-1912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 31205001) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-07-31 |