| NPI | 1841600434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELEANOR ROSE CRAIGHEAD Owner/Sole Proprietor 276-692-6092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: VA 0001153362) |
| Enumeration Date | 2014-05-05 |
| Last Update Date | 2014-05-05 |