| NPI | 1588745566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANTE DE LOS SANTOS BRUNO CEO 434-575-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 53781) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 53781) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2011-01-20 |