| NPI | 1639335987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD L HEYWARD President 804-317-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: VA 118542) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2008-08-05 |