| NPI | 1477986800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW D DODGE Owner 540-885-1735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: VA 0104556995) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2013-11-05 |