| NPI | 1609107507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA BRYANT Owner 757-380-8603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: VA 010102571) |
| Enumeration Date | 2010-01-18 |
| Last Update Date | 2010-01-18 |