| NPI | 1386970218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA HEATH DALTON President 276-365-1286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102202333) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: VA 0102202333) |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2009-10-28 |