| NPI | 1790810455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY GLENN Practice Manager 757-266-5917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2023-09-05 |