| NPI | 1558891887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFTON COFFMAN Authorized Official 804-592-6249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2017-06-21 |