| NPI | 1972042257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON HUDNALL Athletic Trainer/Physician Extender 540-250-3085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: FL AL4490) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |