| NPI | 1548093578 |
|---|---|
| Former Legal Business Name | BLOGRAVIC HEALTH SERVICES |
| Entity Type | Organization |
| Authorized Contact | OLAMIDE M IPEAIYEDA Pmhnp 804-821-8922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-23 |
| Last Update Date | 2025-05-20 |