| NPI | 1952474306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON WALKER THEISZ President 703-533-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101102617) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2023-01-19 |