| NPI | 1740325380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COMDT (CG-1122) Credentialing 202-267-0801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |