| NPI | 1588065429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCINDA LYNN EARLE Registered Dietititan Nutritionist 757-623-9014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |