| NPI | 1477105153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL CHAMBERS Manager Insurance Credentialing 540-536-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2024-09-06 |