| NPI | 1629122932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY WRATCHFORD President 804-559-2916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101234730) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101234718) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2008-01-07 |