| NPI | 1326783226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH DENG QIU Owner 804-362-7307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2022-05-11 |