| NPI | 1902357940 |
|---|---|
| Doing Business As | FAVERO FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | JOHN PATRICK FAVERO Owner/President 276-638-7205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173919) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |