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1629155122
INDIAN RIVER FAMILY PRACTICE PC
CHESAPEAKE, VA
NPI
1629155122
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Entity Type
Organization
Authorized Contact
LARRY HOWARD KAGAN
Secretary Treasurer
757-420-8297
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2006-11-01
Last Update Date
2020-08-22
Business Address
INDIAN RIVER FAMILY PRACTICE PC
1016 JUSTIS ST
CHESAPEAKE, VA 23325
Phone number: 757-420-8297
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Mailing Address
INDIAN RIVER FAMILY PRACTICE PC
1016 JUSTIS ST
CHESAPEAKE, VA 23325
Phone number: 757-420-8297
Copy
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