| NPI | 1033517206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LUBBERS Corpsman 907-487-5757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2014-12-19 |