NPI | 1578643326 |
---|---|
Entity Type | Organization |
Authorized Contact | WARREN PHILLIP HENSLEE President 703-241-8768 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101230929) |
Enumeration Date | 2006-10-16 |
Last Update Date | 2020-08-22 |