| NPI | 1205042926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSCAR HARTLEY Ubo Manager 571-231-2866 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2014-04-18 |