| NPI Details | |
|---|---|
| NPI | 1033196480 |
| Enumeration Date | 12/28/2005 |
| Last Updated | 02/28/2014 |
| Entity Type | Healthcare Provider |
| Active | Over 13 years ago |
| Authorized Information | |
|---|---|
| Name | THERESA MARIE THERESA |
| Position | AIR FORCE UBO ANALYST |
| Phone | (660) 687-1838 |
| Fax | (660) 687-5121 |
| Practice Location | |
|---|---|
| 331 SIJAN AVE 509 MDSS SGSR WHITEMAN AFB MO, 65305-1269, US |
|
| Phone | (660) 687-1838 |
| Fax | (660) 687-5121 |
| Business Location | |
|---|---|
| 331 SIJAN AVE 509 MDSS SGSR WHITEMAN AFB MO, 65305-1269, US |
|
| Phone | (660) 687-1838 |
| Fax | (660) 687-5121 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 261QM1101X |
| License State | |
| License Number | |
| Remove 1033196480 NPI Number | |
According to our database, 509th Medical Group-sgsr NPI is 1033196480, taxonomy code is 261QM1101X 509th Medical Group-sgsr physically located at 331 Sijan Ave, Whiteman Afb MO, 65305-1269. NPI Number 1033115704 has the healthcare provider type.
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1033196480 NPI number is provided on an as is basis without warranty of any kind. 1033196480 is maintained by the National Plan & Provider Enumeration System. The contents of 509th Medical Group-sgsr are for informational purposes only.
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