| NPI | 1922244938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J EDWIN WILDER President 540-953-0530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101047913) |
| Enumeration Date | 2008-12-22 |
| Last Update Date | 2023-03-07 |