| NPI | 1942857297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVAUGHN D JOHNSON Chief Oprations Officer 540-219-3895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |