| NPI | 1336226729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MOORE Credentials Coordinator 513-984-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient (Licence: AK 5650) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |