| NPI | 1417973090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD SHANE PALMER Physician/Owner 540-371-7372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: VA 0101235589) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2015-09-09 |