| NPI | 1700048071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENTON D. WEISS Owner 757-490-7545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: VA 0101226095) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |