| NPI | 1962681809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI LENELLE BROWN Sa C 804-862-2975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: VA 07-258) |
| Enumeration Date | 2007-10-28 |
| Last Update Date | 2007-10-28 |