| NPI | 1861605404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMIE PERKINS C, Rm 913-684-6726 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2014-03-17 |