Organization
UNITED STATED COAST GUARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA MARIE PENDARVIS (CORPSMAN)
(508) 968-6703
Entity
Organization
Contact information
Practice address
5201 LEE RD, BUZZARDS BAY, MA 02542-1313
(508) 968-6703
Mailing address
5201 LEE RD, BUZZARDS BAY, MA 02542-1313
(508) 968-6703
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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