| NPI | 1619939089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRAINE JOY CASE Registered Nurse 757-953-9390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient (Licence: VA 0001131486) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2008-08-14 |