Air Force

NPI #1891247706 in Mcchord Afb, Washington

Provider Information

NPI Number: 1891247706
Entity Type: Organization
Organization Name: Air Force
Primary Specialty: Military Health Care Provider - Independent Duty Medical Technicians
Enumeration Date: Oct 26, 2016
Last Updated: Oct 26, 2016

Practice Location

Address: 690 BARNES BLVD
City: Mcchord Afb
State: Washington
ZIP Code: 98438-0000
Phone: (253) 982-5688

Authorized Official

Name: ISAIAH GARY ALLISON
Title: IDMT
Phone: (360) 589-6025

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Health Care Provider - Independent Duty Medical Technicians — Independent Duty Medical Technicians	1710I1003X	Primary

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