| NPI | 1407668569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL CHAMBERS Manager Insurance Credentialing 540-536-0231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology Clinical Neurophysiology |
| Enumeration Date | 2025-01-24 |
| Last Update Date | 2025-07-17 |