| NPI | 1467735324 |
|---|---|
| Former Legal Business Name | FAN FREE CLINIC |
| Entity Type | Organization |
| Authorized Contact | KAREN A. LEGATO Executive Director 804-358-6343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: VA 101042501) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2017-03-24 |