| NPI | 1487352159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT ORLANDO WEBB Director Of Operations 804-376-9114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-02-21 |