| NPI | 1497245500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE BURNETT Authorized Official 804-378-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101226169) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2019-02-27 |