NPI | 1508898420 |
---|---|
Entity Type | Organization |
Authorized Contact | KIMBERLY SPILLER Practice Administrator 804-282-8510 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: VA 101028959) |
Enumeration Date | 2006-07-07 |
Last Update Date | 2013-11-04 |