| NPI | 1548553068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PREM MANCHANDA Owner 703-981-4865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101057630) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2011-11-23 |