| NPI | 1902358625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYARATHNE KOTTAGE Owner 540-752-5887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: VA 0101254569) |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2016-11-10 |