Organization
NHC QUANTICO VIRGINIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAKE GREFALDON CARANDANG (INDEPENDENT DUTY CORPSMAN)
(703) 784-2062
Entity
Organization
Contact information
Practice address
3259 CATLIN AVE, QUANTICO, VA 22134-5109
(703) 784-2062
Mailing address
3259 CATLIN AVE, QUANTICO, VA 22134-5109
(703) 784-2062
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
01/06/2009
Last updated
01/06/2009
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