| NPI | 1861524662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN GLOSSA Medical Director 703-237-3446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0024100278) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2020-08-22 |