| NPI | 1992079404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA DARLENE JANOWITZ Office Manager 703-361-5116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: VA 0101023931) |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2012-03-01 |