| NPI | 1922339076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET MACKRELL GAGLIONE Medical Director 757-644-6819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: VA 0101050879) |
| Enumeration Date | 2010-01-28 |
| Last Update Date | 2010-01-28 |