| NPI | 1285840512 |
|---|---|
| Doing Business As | TMC CON-1-2-4-JACKSON |
| Entity Type | Organization |
| Authorized Contact | WILLIE WARREN Chief, Ubo 803-751-0472 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2015-04-08 |