| NPI | 1770967325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG JOHNSTON Owner/Practinoner 540-444-1043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: VA 0121000321) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |