| NPI | 1861936320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITZI T CREEL Disability 434-394-4244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL C640558626680) |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2016-12-16 |