| NPI | 1346749223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA K CAMERON Billing Manager 671-653-1408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |