| NPI | 1609327428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL WELCH Idmt 940-232-8515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1710I1003X Military Health Care Provider, Independent Duty Medical Technicians |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |