| NPI | 1801010616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN B. LAFAVE President 276-632-9714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: VA 010059135) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |