NPI | 1710310578 |
---|---|
Doing Business As | SAMMC-CENTER FOR THE INTREPID |
Entity Type | Organization |
Authorized Contact | CLENTON BALLARD C, Ubo 210-916-8561 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
Enumeration Date | 2013-08-15 |
Last Update Date | 2019-02-08 |