| NPI | 1568699429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW C LEE Practitioner/Owner 804-358-1492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101239897) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2013-10-11 |