| NPI | 1285847731 |
|---|---|
| Doing Business As | TMC #1 (USDB)-FT LEAVENWORTH |
| Entity Type | Organization |
| Authorized Contact | JIMMIE PERKINS C, Rm 913-684-6726 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2012-12-14 |