Uscg

NPI 1205957982 - Clinic/Center - 261QM1100X

NPI Details
NPI 1205957982
Enumeration Date 04/02/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name WYATT WYATT
Position HEALTH SERVICE TECHNICAN 3 CLASS
Phone (508) 968-6704
Fax
Practice Location
5439 A LEMAY AVE.
BUZZARDS BAY MA, 02542, US
Phone (508) 968-6704
Fax
Business Location
5403 A LEMAY AVE.
BUZZARDS BAY MA, 02542, US
Phone
Fax
Toxanomy
Taxonomy Code 261QM1100X
License State
License Number
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According to our database, Uscg NPI is 1205957982, taxonomy code is 261QM1100X Uscg physically located at 5439 A Lemay Ave., Buzzards Bay MA, 02542. NPI Number 1033115704 has the healthcare provider type.

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1205957982 NPI number is provided on an as is basis without warranty of any kind. 1205957982 is maintained by the National Plan & Provider Enumeration System. The contents of Uscg are for informational purposes only.