| NPI | 1639314370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY A STEPHENSON Partner/Admin 757-485-9870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101043479) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2008-12-10 |