| NPI | 1881619690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVONDA NIQUITA HURT Insurance,Billing Coordinator 804-644-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2010-09-22 |