This practice has really gone down hill. I was a patient here for 20 years and since Carilion took over, the care is just substandard from all aspects. The place is very, very dirty and outdated with broken bathroom facilities and junky treatment room equipment. On more than one occasion I spent an hour past my appointment time waiting in that horribly painted(dark grey) waiting room with mangled magazines from nineteen-forgotten, just to have the doctor spend less than five minutes with me when I finally did see him! The reception staff is very rude, leaving people at the window unattended when they were right there and not on the phone. One bulled right in the middle of the conversation I was having witht he receptionist to discuss the lunch schedule, leaving me standing there to listen. The office manager does not take staff in hand and seems to just be putting in her«30 years». They now wear JEANS, come in late and keep patients waiting for blood work first thing in the morning, and are dirty and unkempt. I walked out for good the last time when Amanda was going to make another feeble attempt to get my blood and her fingernails were incredibly dirty, and she will not put on gloves to do this! She has not been properly trained in venipuncture procedures, and patients are NOT a pin cushion to be practiced upon. I transferred my records. The heck with long-standing loyalty.