| NPI | 1417978768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN L FOX CEO 804-282-9425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2011-11-30 |