| NPI | 1801776539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE WINSTON DIAL Owner/Manager 757-719-6256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-09-04 |
| Last Update Date | 2025-09-04 |