| NPI | 1538205521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM REESE Owner 540-710-1086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101047986) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |