| NPI | 1689892416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY S LAMBERTH Billing Manager 434-572-9210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 0104555720) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2008-03-11 |