| NPI | 1669631917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESE D HUNTER Operation Manager 804-249-4740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: VA HCO09439) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2008-07-21 |