| NPI | 1336589993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BRUMAGE Deputy Chief Of Clinical Services 315-263-4606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1103X Clinic/Center, Military Ambulatory Procedure Visits Operational (Transportable) (Licence: VA 0001227332) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2013-06-27 |