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Organization
UNITED STATES COAST GUARD
Active
Organization
UNITED STATES COAST GUARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ALLEN (LIEUTENANT)
(251) 441-6411
Entity
Organization
Contact information
Practice address
8501 TANNER WILLIAMS RD, MOBILE, AL 36608-8322
(251) 441-6561
(251) 441-6415
Mailing address
8501 TANNER WILLIAMS RD, MOBILE, AL 36608-8322
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
AL
Other
Enumeration date
12/23/2005
Last updated
08/22/2020
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