| NPI | 1710461215 |
|---|---|
| Other Name | PROVIDENCE VA CLINIC |
| Entity Type | Organization |
| Authorized Contact | ERIN DENISE POTTER Npi Team Member 202-382-2579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA |
| Enumeration Date | 2018-09-20 |
| Last Update Date | 2023-01-10 |