| NPI | 1467742627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COMMANDING OFFICER Commanding Officer 757-433-5181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1710I1002X Military Health Care Provider, Independent Duty Corpsman (Licence: VA T61636789) |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2011-04-08 |