| NPI | 1366631038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY K HOOVER President 804-264-4545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101-053613) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101-334798) |
| 207N00000X Dermatology (Licence: VA 0101-239915) | |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2007-10-18 |