| NPI | 1669772943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE KRUELLE Billing Specialist 703-777-7477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2010-11-02 |