| Organization Name: | FAMILY HEALTHCARE OF WYTHEVILLE, PC |
| NPI Number: | 1316330251 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TARA D HARTMAN (FAMILY NURSE PRACTITIONER) |
| Mailing Address: | 1040 Holston Rd Wytheville |
| State: | VA US |
| Postal Code: | 243824107 |
| Phone Number: | 2762270200 |
| Fax Number: | 2762270202 |
| NPI Enumeration Date: | 03/17/2015 |
| NPI Last Update Date: | 03/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 0024172439 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |