| NPI | 1679210181 |
|---|---|
| Doing Business As | COUNTRY NURSE PRACTITIONER |
| Entity Type | Organization |
| Authorized Contact | JASON PATRICK ITSON Nurse Practitoner 540-330-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2022-06-21 |