United States Navy
NPI #1386886489 in Charleston, Washington
Provider Information
- NPI Number
- 1386886489
- Entity Type
- Organization
- Organization Name
- United States Navy
- Primary Specialty
- Clinic/Center - Military Ambulatory Procedure Visits Operational (Transportable)
- Enumeration Date
- Apr 3, 2009
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 3600 RIVERS AVE
- City
- Charleston
- State
- Washington
- ZIP Code
- 29405
- Phone
- (843) 574-8242
Authorized Official
- Name
- SHANE C HICKS, IDC
- Title
- INDEPENDENT DUTY CORPSMAN
- Phone
- (843) 574-8242
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Military Ambulatory Procedure Visits Operational (Transportable) — Military Ambulatory Procedure Visits Operational (Transportable) |
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