| NPI | 1730207689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE SMITH Office Manager 276-628-3144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0018965774) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2023-11-07 |