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Organization
FEDERAL GOVERNMENT
Active
Organization
FEDERAL GOVERNMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONITA PORTER (CHIEF ADMINISTRATOR)
(912) 435-6633
Entity
Organization
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5454
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
GA4170
GA
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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