| NPI | 1972530210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA P. TATE Vice President 540-371-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101043865) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101237959) |
| 208000000X Pediatrics (Licence: VA 0101241779) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2014-10-23 |