| NPI | 1396915138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | A LARRY MILLER Owner 703-938-5660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: VA 0101026494) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2008-03-07 |