| NPI | 1619400066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY ELIZABETH JACKSON CIO 757-873-1554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QX0100X Clinic/Center, Occupational Medicine | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2019-06-11 |