| NPI | 1639305543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BURLINGAME Ubo Manager 719-526-7291 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2018-02-26 |