NPI | 1821410242 |
---|---|
Entity Type | Organization |
Authorized Contact | AMANDA LEE GONZALEZ Nremt 334-255-7636 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient (Licence: TX E2089197) |
Enumeration Date | 2014-01-21 |
Last Update Date | 2014-01-21 |