| NPI | 1578648093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA RODRIGUEZ Chief, Health Services Division 617-223-3121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |