| NPI | 1992904353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY D. HARDEE Md/Owner 540-345-7103 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: VA 0101036158) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |