| NPI | 1790868339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA SHELOR Office Manager 434-316-7199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2018-11-07 |