| NPI | 1568668655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA DICKSON Supervisor Revenue Collection 301-295-4934 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1102X Clinic/Center, Military Outpatient Operational (Transportable) Component |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2008-07-11 |