| NPI | 1780875633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CURTIS RUSSELL BRYAN Medical Director 757-486-0178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: VA 0101041906) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |