Organization
PRIMARY MULTISPECIALTY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESE T. CHONG (PATIENT RELATIONS COORDINATOR)
(671) 688-1066
Entity
Organization
Contact information
Practice address
177 CHALAN PASAHERU STE C, TAMUNING, GU 96913-4161
(671) 647-6201
(671) 647-0045
Mailing address
177 CHALAN PASAHERU # A, STE F, TAMUNING, GU 96913-4161
(671) 647-6201
(671) 647-0045
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
LEO 196
GU
Other
Enumeration date
04/24/2009
Last updated
04/24/2009
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