| NPI | 1366560229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA ELISE GLASSON President 757-412-1005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 225100000X Physical Therapist | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2016-05-12 |