| NPI | 1558332114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERISE D. TRIPLETT Office Manager 276-676-1133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 207qa00000x) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2020-08-22 |