| NPI | 1952285181 |
|---|---|
| Doing Business As | OLD FAITHFUL |
| Entity Type | Organization |
| Authorized Contact | SUZANNE SUZANNE KANG Project Manager 703-578-6030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-08-01 |
| Last Update Date | 2025-08-01 |