| NPI | 1689854846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLIVETTE GUEDON Owner 540-446-2278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: VA 0101221402) |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2007-11-05 |