| NPI | 1356646814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY L RIEDT President 804-784-4098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2015-09-23 |