| NPI | 1902116049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE RENEE REILLO Director 804-296-4094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: FL Rn9303002) |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2012-09-21 |