Organization
UNITED STATES COAST GUARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS STEPHANIE LUBBERS (CORPSMAN)
(907) 487-5757
Entity
Organization
Contact information
Practice address
BASE KODIAK BUILDING N-46, KODIAK, AK 99619
(907) 487-5757
Mailing address
BASE KODIAK BUILDING N-46 CAPE SARICHEF, KODIAK, AK 99619
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Enumeration date
12/19/2014
Last updated
12/19/2014
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