| NPI | 1538946777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YLBANIA JOHNSON Practice Administrator 540-455-3216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 208000000X Pediatrics |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2023-10-13 |