| NPI | 1376879411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD ANTHONY WHEELER Executive Director 804-272-2277 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 118105001) |
| Enumeration Date | 2009-10-25 |
| Last Update Date | 2009-10-25 |