| NPI | 1508263088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA S WILLIAMS President 276-935-7515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024168117) |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2014-12-01 |