| NPI | 1922214782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHONG MCCUE Chief, Ubo 0118227-917-1857 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1100X Clinic/Center Military/U.S. Coast Guard Outpatient |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2014-01-03 |