| NPI | 1639460009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEIGH RAUBENOLT Consultant 540-371-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101035076) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2011-06-28 |