| NPI | 1982752648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN ALBERT Manager 434-984-2846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101029437) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2013-12-14 |