| NPI | 1376510644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA R NEAL Billing Manager 434-792-3730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101053147) |
| Enumeration Date | 2006-03-04 |
| Last Update Date | 2013-04-18 |