INDIVIDUAL PROVIDER

EGLIN, FL
NPI1376890293
Entity TypeOrganization
Authorized ContactCHUONG NGUYEN THAI
Major
850-883-9055
Organization Subpart ?No
Primary Taxonomy286500000X Military Hospital
Enumeration Date2012-08-09
Last Update Date2012-09-14
Business Address
INDIVIDUAL PROVIDER
307 BOATNER ROAD SUITE 114 96TH MEDICAL GROUP
EGLIN, FL 32542
Phone number: 850-883-8600
Mailing Address
INDIVIDUAL PROVIDER
307 BOATNER ROAD SUITE 114 96TH MEDICAL GROUP
EGLIN, FL 32542
Phone number: 850-883-8600