| NPI | 1942651054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH NOONAN Pediatrician/Owner 276-638-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101240119) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2024-05-16 |