| NPI | 1235442328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA HOLMES Chief, Ubo 571-801-6238 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2025-03-14 |