| NPI | 1588393318 |
|---|---|
| Other Name | JACKSON 1 VA CLINIC |
| Entity Type | Organization |
| Authorized Contact | ERIN DENISE POTTER Npi Team Lead 202-382-2579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-06-07 |