| NPI | 1669862215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX P TAYLOR Secretary/President/Owner 757-622-0453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101231062) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |