| NPI | 1932504446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE S HUTTON Owner 540-560-4676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101242820) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |