| NPI | 1881052165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILONA M OWENS Office Manager 703-327-3173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: VA 0101244923) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |