NPI | 1003051210 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTOPHER SCOTT BRACKMAN Pa 910-988-6117 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient (Licence: NC 0010-01314) |
Enumeration Date | 2008-12-03 |
Last Update Date | 2008-12-03 |