U.s. Coast Guard

NPI #1760673032 in New London, Connecticut

Provider Information

NPI Number
1760673032
Entity Type
Organization
Organization Name
U.s. Coast Guard
Primary Specialty
Clinic/Center - Military/U.S. Coast Guard Outpatient
Enumeration Date
Aug 5, 2007
Last Updated
Aug 5, 2007

Practice Location

Address
15 MOHEGAN AVE
ZIP Code
06320-8100
Phone
(860) 444-8402

Authorized Official

Name
MR. SCHON RUSSELL
Title
CHIEF
Phone
(860) 701-6736

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Military/U.S. Coast Guard OutpatientMilitary/U.S. Coast Guard Outpatient

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