| NPI | 1710215595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WILSON MELLON President 276-451-5470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101242000) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2009-12-07 |