| NPI | 1700341468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRKPATRICK KAPUA CONLEY President 757-736-2655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2019-02-07 |