| NPI | 1942746938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY HARMON Office Executive 804-925-2566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101254065) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-01-13 |