# KENNER ARMY HEALTH CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164640504
- **Authorized official:** MR. JOSEPH EUGENE WATSON (LICENSED PRACTICAL NURSE)
- **Authorized official phone:** (804) 734-9449

## Contact information

- **Practice address:** 700 24TH ST, FORT LEE, VA 23801-1716
- **Practice address phone:** (804) 734-9449
- **Practice address fax:** (804) 734-9053
- **Mailing address:** 11719 WALNUT WOOD CT, MIDLOTHIAN, VA 23112-3268
- **Mailing address phone:** (804) 595-1602

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 0002041915 | VA | Yes |

## Other

- **Enumeration date:** 04/23/2007
- **Last updated:** 08/12/2008