| NPI | 1619195526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE (ANN WEST) HANCOCK Director 703-909-0299 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: VA 0001068875) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2009-08-07 |