| NPI | 1033532486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUE SHELLA MAGANA Medical Support Assistant 334-255-7530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |