| NPI | 1750510376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH FORESTIERE President 757-490-2855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101026971) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |