| NPI | 1538459219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE CHACONAS President 540-588-7115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: VA 0101038267) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |