| NPI | 1558457895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES V. TERRY President 804-754-3776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: VA 0101039466) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |