| NPI | 1598966848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE A GUY Idc 360-315-4363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1710I1003X Military Health Care Provider Independent Duty Medical Technicians |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |