| NPI | 1831109271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA MARLENE BLOCKER-PALMER Practice Administrator 757-461-4278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: VA 0101035788) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |