| NPI | 1699082446 |
|---|---|
| Other Name | LACKEY FREE FAMILY MEDICINE CLINIC |
| Entity Type | Organization |
| Authorized Contact | ROBERT BRADLEY Executive Director 757-886-0608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0024164154) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2010-08-31 |