| NPI | 1396138699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA FULLLER SIKES Owner/Doctor 757-496-9698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: VA 0304000608) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2015-03-10 |