| NPI | 1760673032 |
|---|---|
| Other Name | U.S. COAST GUARD ACADEMY CLINIC |
| Entity Type | Organization |
| Authorized Contact | SCHON RUSSELL Chief 860-701-6736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |