| NPI | 1679628499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZELDA WEST JOHNSON Managing Member 804-644-5440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101057120) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2011-05-24 |